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� CITY OF ORONO PERMIT NO.: 2009-00477 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �ssuEn: 08/1U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 110 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0015 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> NOTE: PLEASE FILL IN THE FOLLOW[NG: <br /> VALUATION OF PERMIT: $ 460,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADVANCED PLAN REVIEW FOR NEW STRUCTURE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO: I3UILDING PERMII�#2009-00475 <br /> APPLICANT ADVANCED PLAN REVIEW 2,090.89 <br /> HOMET[ME VIDEO PUBLISHING, INC. TOTAL 2,090.89 <br /> 4355 PEAVEY ROAD <br /> CHASKA, MN 55318- <br /> (952) 856-4611 <br /> Minnesota State License#: 20456399 <br /> OWNER <br /> Hometime Video Publishing ���� !�i��`� <br /> HOMETIME VIDEO PUBLISHING ,, ,,�_., <br /> AGREEMENT AIYD 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 �>�!4i:! <br /> State Building Code. This permit is for only the work described and does �„ , �- <br /> � �..;�kL'.�.�CJ2i;� �.$cCl t,�' <br /> not grant permission for 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 �,.:�i, r��� ��j� �_��c, <br /> suspended for a period of 180 days at any time atter work has commenced. j.�;•� <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 /> / / �'/ !// � 7c� <br /> Applicant Permitee Signature Date I ed By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />