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CITY OF ORONO * z 0 1 2 - 0 1 1 7 6 * <br /> 2750 KELLEY PARKWAY �AT� �SSUE�: 11/16/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1860 FOX ST <br /> PIN : 03-117-23-42-0016 <br /> LEGAL DESC : WALDRON WOODS <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> COIYSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 750,000.00 <br /> NOTE: PLf�,ASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMI'I�: $ 750,000.00 <br /> I'YNE OF PERMI"f THIS PAYMENT[S FOR: NEW S[NGLE FAMILY HOME <br /> PEI2M[T#THIS PRE-PAYMENT IS T[ED TO:2012-01 177 <br /> APPLICANT ADVANCED PLAN REVIEW 3,05939 <br /> SWANSON HOMES TOTAL 3,059.39 <br /> 1360 HAMEL ROAD <br /> MEDINA, MN 55340- <br /> (763)478-0320 <br /> Minnesota State License#: 627982 <br /> OWNER <br /> OLSON, MICHAEL&JENNIFER <br /> 3924 UPTON AVE S <br /> MINNEAPOLIS, MN 55410- <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 /> Stat�13uilding Code. This permit is for only the work described and docs <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not speciticd herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenecd 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 /> fhe applicant is responsible for assuring all rcquired inspections are <br /> requested in conforniance with the State Building Code.This perniit may be <br /> revoked at any t�me for due cause. <br /> / / � // / / / 02� <br /> Applicant Permitce Signature Date Issu I3y Signature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />