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CITY OF ORONO * 2 0 1 2 - B Q1 3 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/02/2012 <br /> ORONO,MN 55356- ', <br /> 952 249-4600 FAX: 952 249-4616 � ' <br /> ADDRESS : 4149 HIGHWOOD RD <br /> PIN : 07-117-23-44-0018 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 022 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 12,500.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 12,500.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING-DECK <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00353 <br /> APPLICANT ADVANCED PLAN REVIEW 153��0 <br /> IRONWOOD CARPENTRY,LLC TOTAL 153.40 <br /> 443 UNION PLACE <br /> EXCELSIOR,MN 55331- PAID WITH CC# 9454 <br /> (952)201-7937 <br /> Minnesota State License#:BC638723 <br /> OWNER <br /> KOCH,MARK&NANCY <br /> 4149 HIGHWOOD RD <br /> MOUND,MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this perrnit 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 da[e of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <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 Bv Si¢nature ' Date <br />