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CITY OF ORONO * 2 0 1 7 - OJ 0 1 4 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/2U2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 701 DICKEY LAKE DR <br /> PIIY : 34-118-23-22-0005 <br /> LEGAL DESC : R[NGERSWOOD <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 350,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 350,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOUSE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00146 <br /> APPLICANT ADVANCED PLAN REVIEW 1,74520 <br /> GONYEA HOMES TOTAL 1,745.20 <br /> 1000 BOONE AVE N#400 Payment(s) <br /> CHECK 13685 1,745.20 <br /> GOLDEN VALLEY, MN 55427- <br /> (612)741-9069 <br /> Minnesota State License#: BUIL-2459 <br /> OWNER <br /> PUGH, PATRICK&KAREN <br /> 701 DICKEY LAKE DR <br /> LONG LAKE, MN 55356- <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 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 l80 days a[any time afrer 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 /> � �� � � a� �/ <br /> Applicant Permitee Signature Date Issued By ignature Date <br />