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CITY OF ORONO PERMIT NO.: 2010-01155 <br /> � 2750 KELLEY PARKWAY <br /> ' ORONO, MN 55356- DATE ISSUED: 1U24/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> REPRIN"fED ON 11/30/2010 <br /> ADDRESS : 1 190 LYMAN AVE <br /> PIN : 35-I18-23-43-0034 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1067 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 320,000.00 <br /> NOTG: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OP PERM17': $ 320,000.00 <br /> TYPE Ol;PERMI"1'THIS PAYMENT IS FOR: ADDITION <br /> PERMI"I'# I'I IIS PRE-PAYMGNT IS TIED TO: [3LDG PGRMIT-2010-01 1�6 <br /> APPLICANT ADVANCED PLAN REVIEW 1,544.89 <br /> CHOICE WOOD COMPANY TOTAL 1,544.89 <br /> 3300 GORHAM <br /> ST. LOUIS PARK, MN 55426 PAID WITH CC# 4199 <br /> (612)924-0043 <br /> Minnesota State License#: 1532 <br /> OWNER <br /> PALMER, BRIAN &JULIA <br /> 1 190 LYMAN AVE <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall bc performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State[3uilding 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 eompied with���heU�er or not specified herein.This pennit 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 Cor a period of 180 days at any time after work has commenecd. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State[3uilding Code.This permit may be <br /> revoked at any time for due cause. <br /> / / �) <br /> � Applicant Permitee Signature Date ���'�'����� C������� � �� ������ <br /> Issued By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />