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CITY OF ORONO * z p� 1 4 - 0 1 PJ 9 9 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: 09/30/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1 141 F:[,MWOOD AVE <br /> PIN � : 07-117-23-14-0027 <br /> LEGAL DF,SC : SKARP& LINDQUISTS FERNHILL LA <br /> : L,OT 007 BLOCK 000 <br /> PERM[T TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 345,000.00 <br /> NO"I�E: PI,EASE FILL IN"I'l1E FOLLOWING: <br /> VALUATION OF PERMI"I�: $ 345,000.00 <br /> "I�YPF;OF PF,RMIT THIS PAYMEN"I'IS FOR: NF.W I IOUSE <br /> PI�;RMI�I�#"I'FiIS NRI�,-PAYMI�;N"C IS"I�1t:D"I�O: PI�:RM1�1�-201d-Ol 100 <br /> APPLICANT ADVANCED PLAN REVIEW 1,642.39 <br /> TOTAL 1,642.39 <br /> DEAN JOHNSON HOMES, INC. Payment(s) <br /> 4700 CTY ROAD 19 CHECK 41 10 1,642.39 <br /> MEDINA, MN 55357- <br /> (763)479-4820 <br /> Minnesota State License#: BUIL-20639439 <br /> OWNER <br /> ALNESS, RYAN & STACY <br /> 1141 ELMWOOD AVE <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this perniit is issued shall be performed accordin�to <br /> die approved plans and specitications,applicablc City approvals,and thc <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission 1�or additional or related work which requires separatc <br /> permits. AII provisions of laws and ordinances governing this type of�work <br /> shall be compied with whether or not specitied herein."I'his permil will <br /> expire and becomc null and void if construction authorized is not <br /> commenced within 180 days of thc date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after�vork has commenced. <br /> The applicant is responsible Yor 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 [ssued By Signature Date <br /> I <br />