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CITY OF ORONO � 0l1LWullll31l1111� � 1 9 2 * <br /> 2750 KELLEY PARKWAY �ATE �SsuEu: 03/2U2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3460 BIRCH LA <br /> PIN : 08-117-23-43-0027 <br /> LEGAL DESC : LYDIARDS PARK LAKE MTKA <br /> : LOT 019 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 55,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT: $ 55000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS POR: BUII,DING PERM[T <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2013-00193 <br /> APPLICANT ADVANCED PLAN REVIEW 467.51 <br /> M& M HOME CONTRACTORS <br /> TOTAL 467.51 <br /> 205 WINKLER TRAIL <br /> COLOGNE, MN 55322- PAID WITH CC# 1137 <br /> (612)554-2556 <br /> Minnesota State License#: BC560376 <br /> OWNER <br /> LISLE, STEVEB&ANGELA <br /> 3460 BIRCH LA <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 E3uilding Code. This permit is for only the work described and does <br /> not grant permission Yor additional or related work which requires separate <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 are <br /> requested in conformance with the State Building Code.This permi[may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED AB E. <br />