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CITY OF ORONO * 2 0 1 2 — 0 fd 9 7 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/28/2012 <br /> ORONO, MN 55356- <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 : $ 90,000.00 <br /> NOTE: PLEASE F1LL IN THE FOLLOWING: <br /> VALUA'I'ION OF PERMIT:$ 90000.00 <br /> TYPE OF PERMIT THIS PAYMENT[S FOR: BU[LDING PERMI'I'-POOL <br /> Pf',RMIT#7�HIS PRE-PAYMGNT IS T1GD"I'O:2012-00980 <br /> APPLICANT <br /> STEINER& KOPPELMAN ADVANCED PLAN REV[EW 638.14 <br /> 18340 MINNETONKA BLVD TOTAL 638.14 <br /> DEEPHAVEN, MN 55391- PAID WITH CC# 1072 <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 tiu which this permit is issued shall bc performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This pennit 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 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 applican � ponsible for assuring all required inspections are <br /> requeste � confor an ith the State Building Code.This permit may be <br /> revok at any ti r du cause. <br /> / �� / �� / i <br /> �ca� er rtee gnature Date Issued C3y S' ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />