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CITY OF ORONO PERM[T NO.: 2009-00232 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUE�: OS/15/2009 <br /> � ' 952 249-4600 FAX: 952 249-4616 <br /> AUDRESS : 1981 FAGERNESS POINT RD <br /> PIN : 18-117-23-14-0005 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 004 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REV[EW <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT: $ 440000 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT ADVANCE PLAN REVIEW <br /> PERMI"C#"I'HIS PRE-PAYMENT IS TIED TO: 2009-00233 <br /> APPLICANT ADVANCED PLAN REVIEW 2,012.89 <br /> MICHAEL GALLUS CONSTRUCTION INC. TOTAL 2,012.89 <br /> 6306 EHLER AVE. <br /> DELANO,MN 55328 <br /> (612)709-9796 <br /> Minnesota State License#: 20061956 <br /> OWNER <br /> WHITTINGTON-GGROENKE, MICHEAL&JULIE �''' ``�``"' � �'� `� � � � - <br /> :�rn'� �'�d r.'��>`i.: _-- <br /> 1981 FAGERNESS PT RD - <br /> WAYZATA, MN 55391- .+��E�i ��=: �;,{�;"` <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according[o <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 �,�y�"r�F�;�r?yj;p �;��r;! <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing[his type of work ., " <br /> shall be compied with whether or not specitied 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 I 80 days at any[ime atter work hu 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 REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />