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CITY OF ORQNO * Z 0 1 3 - 0 0 0 0 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU04/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> REPRINTED ON 2/11/2013 <br /> ADDRESS : 4156 HIGHWOOD RD <br /> PIN : 07-117-23-44-0019 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 023 BLOCI��000 . <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL , . <br /> CONSTRUCTIOI�i TYPE : ADVANCED PLAN REVIEW . <br /> VALUATION : $ 425,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ $425,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO: 2013-00005 <br /> APPLICANT ADVANCED PLAN REVIEW 1,934.89 <br /> DENALI CUSTOM HOMES TOTAL 1,934.89 <br /> 18352 MINNETONKA BLVD. <br /> DEEPHAVEN,MN 55391- <br /> (952)476-2679 <br /> Minnesota State License#:20175394 <br /> OWNER <br /> MUSGJERD, SCOTT&MELISSA <br /> 4156 HIGHWOOD RD <br /> MOLJND,MN 55364- <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,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 sepazate <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 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 Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />