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CITY OF ORONO * 2 0 1 7 - a 0 0 6 8 * <br /> 2750 KELLEY PARKWAY DATE [SSUED: OU24/2017 <br /> ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRFSS : 2995 DEER RUN TR <br /> PIN : 04-117-23-23-0030 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 500,000.00 <br /> NOTE: PLEASE FILL[N THE FOLLOWING: <br /> VALUATION OF PERM[T:$ 500,000.00 <br /> TYPE OF PERMIT THIS PAYMENT[S FOR: GREAT ROOM ADDITION <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00067 <br /> APPL[CANT ADVANCED PLAN REVIEW 2,359.45 <br /> TOTAL 2,359.45 <br /> NOR-SON INC Payment(s) <br /> 700 LAKE STREET E CRED[T CARD 2737 2,359.45 <br /> WAYZATA, MN 55391- <br /> (952)767-7949 <br /> Minnesota State License#: BUIL-BC001969 <br /> OWNER <br /> LEISCHOW, KELLY <br /> 2995 DEER RUN TR <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according ro <br /> the approved plans and specifications,applicable Ciry approvals,and the <br /> State E3uilding 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 rype 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 /> Thc 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 /> ;�> <br /> � /�Z�� � / �C���.. ) `�-�--� Z- 1 � � f <br /> � � <br /> A�pplicant ermit e Sign re Date Issued By Signature � Date <br />