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F CITY OF ORONO PERMIT NO.: 2o�i-oo6�s <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �A'i'E issUEn: 07/1ll2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3350 FOX ST <br /> PIN : OS-117-23-44-0008 <br /> LEGAL DESC : FULLERTON ESTATES <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 849,570.00 <br /> NOTE: PLEASE FILL IN"I'HF,FOLLOWING: <br /> VALUATION OF PERMIT: $849,570.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION REMODEL <br /> PERMIT#TH[S PRE-PAYMGNT IS TIED TO:PGRMIT#20 1 1-006 1 6 <br /> SHOULD HAVE PAID$3,38439-HAD CK MADE OU'r FOR$3,381.14=OWF,$3.25 <br /> APPLICANT ADVANCED PLAN REVIEW 3,384.39 <br /> STEINER& KOPPELMAN <br /> 18340 MINNETONKA BLVD TOTAL 3,384.39 <br /> DEEPHAVEN, MN 55391- PAID WITH CASH 3.25 <br /> (612)473-5435 <br /> Minnesota State License#: 3721 <br /> OWNER <br /> BIGOS,NANCY <br /> 3350 FOX ST <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued sha11 be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> Statc Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which rcquires 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 180 days at any time after work has conunenced. <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 /> / / l�oZ—1 / <br /> Applicant Permitec Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />