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4 �' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * � 0 1 2 — 0 0 5 4 4 * <br /> DATE ISSUED: 06/15/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1300 FRENCH CREEK DR <br /> PIIV : 10-117-23-32-0015 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 007 BLOCK 002 City af Orono <br /> PERMIT TYPE : ADVANCED PLAN REVIEW 2750 Kelley ParkNay <br /> PROPERTY TYPE : RESIDENTIAL �0� � � �-�4�-� <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW Receipt No: 3.00705P 1un 18, 2012 <br /> VALUATION : $ 25,000.00 I <br /> NO"1'E: PLEASE FILL[N THE FOLLOWING: <br /> Rrestige P�,ls <br /> Previous Balance: .00 <br /> VALUATION OF PERMIT:$ 25000.00 Per'I11t5 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: [3UILDING PERMIT-POOL 2012-40544 1300 French 268.45 <br /> PERMIT#THIS PRE-PAYMENT IS TIED T02012-00544 Cr2ek Dr <br /> 1Q1-34410 <br /> Plan ChecklSite Exas Fees <br /> Total: 268.45 <br /> Check ------------ <br /> Check No: Ib634 268.45 <br /> Payor: <br /> Prestige Pools <br /> Total Applied: 268.45 <br /> Change Tendered: .00 <br /> 06/18/�012 12:03PM ~ � <br /> APPLICANT ADVANCED PLAN REVIEW 268.45 <br /> PRESTIGE POOLS TOTAL 268.45 <br /> 3 E. LITTLE CANADA RD <br /> ST. PAUL, MN 55117 <br /> OWNER <br /> � > A �N R�5 p <br /> 1300 FRENCH CREEK DR <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,applieable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> no[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 wi[h whether or no[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 atter work has commenced. <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 /> / / / / <br /> Applicant Permitee Signature Date Issued By S'g ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />