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CITY OF ORONO * Z 0 1 5 - 0 0 4 1 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/10/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1340 FOX ST <br /> PIN " : 02-117-23-31-0019 <br /> LEG�lL DESC : MINNETONKA BLUFFS <br /> � : LOT 000 BLOCK 014 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOl�1 TYPE : ADVANCED PLAN REVIEW <br /> VALUATTON : $ 850,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 850,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-00413 <br /> APPLICANT ADVANCED PLAN REVIEW 3,553.61 <br /> TOTAL 3,553.61 <br /> CHAMBERLAIN FINE CUSTOM HOMES Payment(s) <br /> 11578 CHAMBERLAIN CT CHECK 925 3,553.61 <br /> EDEN PRAIRIE,MN 55344- <br /> Minnesota State License#: BUIL-BC661410 <br /> OWNER <br /> City ot Oro[io <br /> Chamberlain Capital LLC 2750 Kelley �'arkway ���-�4y--Gg�10 <br /> 1 I 578 CAHMBERLAIN COURT Orono MN 5�.�56 <br /> EDEN PRAIRIE, MN 55344- Receipt No: 3.01314� Apr 10, 2U1'i <br /> Chamber;ain Fina Custom Home:: <br /> AGREEMENT AND SWORN STATEMENT Previous Balanre: .UO <br /> F'8rfi1itS <br /> The work for which this permit is issued shall be performed according to 2015-00414 1340 Fox St 3,553.h 1 <br /> the approved plans and specifications,applicable City approvals,and the 101-34410 <br /> S[ate Building Code. This permit is for only the work described and does P 1211 Check/Si te Exam Fees <br /> not grant permission for additional or related work which requires separate T��t�l: 3,553.t;l <br /> permits. All provisions of laws and ordinances governing this type of work ______________- <br /> shall be compied with whether or not specified herein.This permit will Cherk <br /> expire and become null and void if construction au[horized is not CfleCk No: 925 3.55'•ti 1 <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 /> � � � ���� �� �� <br /> �...����.�.��- ��/s :�-� �,�,v�c�.�-� � G; �S <br /> Applicant Permitee Signat�re Date Issued By Signature Date <br />