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CITY OF ORONO <br /> • * Z 0 1 2 — 0 0 2 7 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/10/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4156 HIGHWOOD RD <br /> PIN : 07-117-23-44-0019 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 023 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RES[DENT[AL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 15,000.00 <br /> NO"I'E: PLGASG FILL IN"l HE FOLLOWING: <br /> VALUATION OF PERMIT: $ 15,000.00 <br /> TYPG OF PERMIT THIS PAYMENT IS FOIL• I3UILDING PERMIT <br /> PGRMI'I'#'I�HIS PRE-PAYMEN"I'IS TIED'1'0:2012-00272 <br /> APPLICAI�IT <br /> ADVANCED PLAN REVIEW 172.58 <br /> 1ST CHOICE CONSTRUCTION LLC TOTAL 172.58 <br /> 2143 DIAMOND LANE <br /> MOUND, MN 55364- <br /> (763)242-9049 <br /> Minnesota State License#: BC639165 <br /> OWNER <br /> FOSTER, ERIC <br /> 4156 HIGHWOOD RD <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pennit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State E3uilding Code. "I'his permit is for only the work described and does <br /> not grant permission for additional or rclated work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compicd 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 Yor a period of 180 days at any time afrer work has commenced. <br /> The applicant is responsible fo assuring all required inspections are <br /> requcstcd in conformance wit lhe State F3uilding Code.This permit may be <br /> revoked a ny tii due use. <br /> � �tc� � r Z � � <br /> A plicant Permitee Signature Date Issued k3y i nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCR[BED ABOVE. <br />