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CITY OF ORONO PERMIT NO.: 2010-01155 <br /> ` 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- DATE IssUEv: l U24/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1190 LYMAN AVE <br /> PIN : 35-118-23-43-0022 /�,�-v �-��� �%�� <br /> LEGAL DESC : REG. LAND SURVEY NO. 1067 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 320,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 320,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:BLDG PERMIT-2010-01156 <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 /> 1190 LYMAN 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 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 /> , , � // , a� o <br /> Applicant Permitee Signature Date Issue Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />