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CITY OF ORONO * 2 0 1 3 - 0 0 2 8 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/25/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 106 CHEVY CHASE DR <br /> PIN : 36-118-23-41-0033 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 028 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 51,400.00 <br /> NOTE: PLEASE FILL IN T}iE FOLLOWING: <br /> VALUATION OF PERMIT: $51,400.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION <br /> PERMIT#THIS PRE-PAYMENT IS TIED T0:2013-00283 <br /> APPLICANT ADVANCED PLAN REVIEW 452.89 <br /> BAUER BUILDING CO. TOTAL 452.89 <br /> 4628 S LAKE SARAH DR. <br /> MAPLE PLAIN, MN 55359 PAID WITH CC# 5361 <br /> (612)382-2880 <br /> Minnesota State License#: 20626864 <br /> OWNER <br /> JOHNSON, MR. & MRS. <br /> 106 CHEVY CHASE DR <br /> WAYZATA, MN 55391- <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 permi[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 are <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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />