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CITY OF ORONO * 2 0 1 5 - 0 1 0 9 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/27/2015 <br /> � ORONO,MN 55356- <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3422 LIVINGSTON AVE <br /> PIN : 17-117-23-43-0022 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 021 BLOCK 002 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 93,386.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$93386.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: FIRE REPAIR-INTERIOR REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-00992 <br /> APPLICANT ADVANCED PLAN REVIEW 690.66 <br /> SYNERGY BUILDERS TOTAL 690.66 <br /> 900 NORTH 3RD STREET Payment(s) <br /> CREDIT CARD 8570 690.66 <br /> MINNEAPOLIS,MN 55402- <br /> (612)305-7090 <br /> Minnesota State License#:BUIL-BC689368 <br /> OWNER <br /> ANDERSON&MATT LABODA,LUKE <br /> 3422 LIVINGSTON AVE <br /> WAYZATA,MN 55391 <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 separate <br /> permits. All provisions of laws and ordinances goveming 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 pertnit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />