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CITY OF ORONO PERMIT NO.: 2009-00456 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUEn: 08/05/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1880 FOX ST <br /> PIN : 03-117-23-42-0015 <br /> LEGAL DESC : WALDRON WOODS <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> NOTE: PLEASE FILL IN THE FOI,LOWING: <br /> VALUATION OF PERMIT: $ 125,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2009-00457 <br /> APPLICANT ADVANCED PLAN REVIEW 784.39 <br /> JIM MORAS TOTAL 784.39 <br /> 12237 NICOLLET AVE <br /> BURNSVILLE, MN 55337- PAID WITH CC# 4301 <br /> (952)736-7545 <br /> Minnesota State License#: 20393854 <br /> OWNER <br /> BLUM, STEVE <br /> 1880 FOX STREET <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> �I�he�vork for which this permit is issued shall be perYormed according to <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 <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 specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I80 days of the da[e of issuance,or if construction is <br /> suspended for a period of l80 days at any time aiter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code."I'his permit may be <br /> revoked at any time for due cause. , �, <br /> � � - (Y� ���� <br /> � ��r�:���<<a �����, , , 1. t� �� ����<<�� ,�.�, , ,��� <br /> Applicant Permi ee Signature Date Issued[3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />