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, ' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 6 - 0 0 1 7 3 * <br /> DATE ISSUED: 02/17/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3960 BAYSIDE RD <br /> PIN : OS-117-23-22�9t1'1�00<<j <br /> � � <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 "���t: ,,_ <br /> : LOT O55 BLOCK 000 �� ��4'� � '``� <br /> PERMIT TYPE : ADVANCED PLAN REVIEW ���"'`" <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 300,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOW[NG: <br /> VALUATION OF PERMIT:$ 1,540.45 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00172 <br /> APPLICANT ADVANCED PLAN REVIEW 1,540.45 <br /> TOTAL 1,540.45 <br /> MODERN CONSTRUCTION OF MINNESOTA Payment(s) <br /> 621 MAIN ST NW CHECK 1419 1,540.45 <br /> ELK RIVER, MN 55330- <br /> (763)200-6376 <br /> Minnesota State License#: BUIL-BC648528 <br /> OWNER <br /> LOVELESS,CHRISTOPHER&KATIE <br /> 3960 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 construc[ion 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 applic t is responsible for assuring all required inspections are <br /> requested' conformance with the State Building Code.This permit may be <br /> revoked any time fo due ause. <br /> r" �� � ,� /��'� <br /> j� �, � 1�1 �4� ' v �� f ��.�..�.� �f Sc> 2_ l� � � /U <br /> i�"an Permitey ig ature Date Issued By Sign re Date <br /> � �. <br /> „ . <br />