2013-01001 - addn/remodel/repair

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CITY OF ORONO * 2 0 1 3 — 0 1 0 0 0 2750 KELLEY PARKWAY DATE ISSUED: 09/26/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS 1850 FOX RIDGE RD PIN 03-117-23-13-0008 LEGAL DESC FOX RIDGE LOT 004 BLOCK 001 PERMIT TYPE ADVANCED PLAN REVIEW PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADVANCED PLAN REVIEW ACTIVITY 434-RESIDENTIAL VALUATION S 125,000.00 NOTE: PLEASI? FILL IN THE FOLLOWING: VALUATION OF PERMIT: S 125.000 TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION PFRMIT#"PHIS PRF,-PAYMENT IS TIED TO:2013-01001 APPLICANT ADVANCED PLAN REVIEW 784.39 CONSTRUCTION RESOURCE TOTAL 784.39 15724 115TH AVENUE LITTLE FALLS, MN (763)360-6486 Minnesota State License 4: BC447049 OWNER STEPHENSON III ET AL, REVIS L 1850 FOX RIDGE RD LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT I he work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time alter work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.