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CITY OF ORONO I '1 1' 1 111E1 I I [MI <br /> * <br /> ♦• 2750 KELLEY PARKWAY * 2 1 6 - 0 0 0 2 <br /> DATE ISSUED: 01/15/20162016 <br /> t ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2610 WEST LAFAYETTE RD <br /> PIN : 21-117-23-24-0043 <br /> LEGAL DESC : SHORE HILLS <br /> : LOT 011 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 180,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 180,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00053 <br /> APPLICANT ADVANCED PLAN REVIEW 1,049.05 <br /> MCGOWAN DESIGN BUILD INC TOTAL 1,049.05 <br /> Payment(s) <br /> 11180 33RD CIRCLE NE <br /> ST MICHAEL,MN 55376- CREDIT CARD 3076 1,049.05 <br /> Minnesota State License#: BUIL-BC642682 <br /> OWNER <br /> ENQUIST,CYNTHIA <br /> 2610 WEST LAFAYETTE RD <br /> EXCELSIOR, MN 55331 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> Applicant Permitee Signature Date Issued By Signature Date <br />