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CITY OF ORONO * Z pJ 1 5 - 0 1 2 7 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/30/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4565 BAYSIDE RD <br /> PIN : 06-117-23-21-0010 <br /> LEGAL DESC : BAYSIDE BERRY FARM <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : ADVANCED PLAN REV[EW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 58,900.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$58,900.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: POLE BUILDING <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01271 <br /> APPLICANT ADVANCED PLAN REVIEW 511.39 <br /> DENALI CUSTOM HOMES, INC. TOTAL 511.39 <br /> Payment(s) <br /> 18283 MINNETONKA BLVD. CHECK 11741 511.39 <br /> DEEPHAVEN,MN 55391- <br /> (952)476-2679 <br /> Minnesota State License#: BUIL-20175394 <br /> OWNER <br /> DOUBECK,TIM& MARY <br /> 4565 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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />