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CITY OF ORO O PERMIT NO.: 2011-01002 2750 KELLEY P�R AY ORONO, MN 53 fi- DATE ISSUED: 09/06/2011 952 249-4600 FAX: 95 249-4616 � REPRINTED ON /6/201 1 ADDRESS : 4465 BAYSIDE RD PIN : 06-117-23-21-0006 LEGAL DESC : JOHNSON WHEELER 1 ST ADDN : LOT 001 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 2,000.00 N01'E: PAID$49.00 CK#2212,OVERPAID BY$1.06 WHICH WILL BE DEDUCT D FROM PERMIT#201 1-01000. VALUATION OF PERMIT: $ 2,000.00 TYPE OF PGRMIT THIS PAYMENT IS FOR: SCREEN PORCH PERMIT#THIS PRE-PAYMENT IS TIED TO:2011-01000 APPLICANT ADVANCE PLAN REVIEW 49.00 CARLSON, ROBERT 4465 BAYSIDE RD TOTAL 49.00 MAPLE PLAIN, MN 55359- OWNER I CARLSON, ROBERT '� 4465 BAYSIDE RD MAPLE PLAIN, MN 55359- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and [he 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 construc[ion 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 after 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�y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE.