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CITY OF ORONO * Z 0 1 3 - 0 0 2 3 2 * ' <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/10/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 75 LEAF ST <br /> PIN : OS-117-23-11-0014 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 3 <br /> : LOT 1 BLOCK 3 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATIOPI : $ 40,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$40,000 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: SWIMMING POOL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2013-00233 <br /> APPLICANT ADVANCED PLAN REVIEW 373.00 <br /> DOLPHIN POOL&SPA,INC. <br /> 3405 N HWY 169 TOTAL 373.00 <br /> PLYMOUTH,MN 55441- <br /> (612)542-9000 <br /> Minnesota State License#:20266452 <br /> OWNER <br /> KAPSNER,JASON&JULIE <br /> 760 DICKEY LAKE ROAD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 />