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` � CITY OF ORONO * Z 0 1 7 - 0 0 5 3 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/22/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1095 FERNDALE RD W <br /> PIN : 02-117-23-43-0023 <br /> LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 3,500,000.00 <br /> APPLICANT ADVANCED PLAN REVIEW 10,890.70 <br /> WELCH FORSMAN ASSOCIATION TOTAL 10,890.70 <br /> 6026 PILLSBURY AVE S Payment(s) <br /> MINNEAPOLIS,MN 55402- CHECK 34958 10,890.70 <br /> (612)827-4455 <br /> Minnesota State License#: BUIL-BC005890 <br /> OWNER <br /> TOLES, WILLIAM <br /> 2510 CRESENT RIDGE ROAD <br /> MINNETONKA, 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 Ciry 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 governing this type of work <br /> shall be compied with whether or not speci6ed herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 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 />