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CITY OF ORONO * 2 0 1 6 - 0 1 0 4 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/29/2016 <br /> � ORONO, MN 55356- <br /> : (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 565 FERNDALE RD N <br /> PIN : 36-118-23-14-0004 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> COi�ISTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 345,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 345,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL <br /> PERMIT#THIS PRE-PAYMENT[S TIED TO:2016-01039 <br /> APPLICANT ADVANCED PLAN REVIEW 1,724.72 <br /> TOTAL 1,724.72 <br /> SHEP'S CONSTRUCTION Payment(s) <br /> 1620 MARSH AVE CHECK 1096 1,724.72 <br /> MAPLE PLAIN,MN 55359- <br /> (763)479-4465 <br /> Minnesota State License#: BUIL-BC626612 <br /> OWNER <br /> VEIT,TRAVIS <br /> 565 FERNDALE RD N <br /> WAYZATA, MN 55391- <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 /> 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 specified 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 l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring a11 required inspections are <br /> requested in c or c i the State Building Code.This permit may be ��p� <br /> revoked at use. �� <br /> ��;� � � /�-V���C..� � ��-��' � <br /> A p� e Signature Date Issued By Signatur Date <br />