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CITYOFOR NO * 2013 - 00556 * <br /> 2750 KELLEY PAR WAY DATE ISSUED: 06/24/2013 <br /> ORONO, MN 55 56- <br /> (952) 249-4600 FAX: (9 ) 249-4616 <br /> ADDRESS : 4185 BAYSIDE RD <br /> PIN : 06-117-23-14-0012 <br /> LEGAL DESC : NORTH ARM ESTATES 3RD ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 8,200.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT: $8200.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: SHED <br /> PERMIT#THIS PRE-PAYMENT[S'CIED"CO: 2013-00557 <br /> APPLICANT ADVANC D PLAN REVIEW 115.05 <br /> CROWN CONSTRUCTION TOTAL 115.05 <br /> 5249 GOLDEN VALLEY RD <br /> GOLDEN VALLEY, MN 55427- PAID ITH CC# 3291 <br /> (612) 868-1899 <br /> Minnesota State License#: BC450383 <br /> OWNER <br /> REZABEK, ALLAN & SHIRLEY <br /> 4185 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <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 l80 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 a[any time for due cause. <br /> / / / / <br /> Applicant Permitee Signatnre Date Issued y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTH R THAN DESCRIBED ABOVE. <br />