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CITY OF ORONO * 2 0 1 5 - 0 1' S 2 1 * <br /> • 2750 KELLEY PARKWAY DATE [SSUED: 12/03/2015 <br /> ' ORONO, MN 55356- <br /> (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 3438 LYRIC AVE <br /> PIN : 17-117-23-43-0077 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 023 BLOCK 005 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 165,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUAT[ON OF PERMIT:$ 165,000.00 <br /> TYPE OF PERMIT TH1S PAYMENT IS FOR: NEW HOME <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:20 1 5-01 520 <br /> APPLICANT ADVANCED PLAN REVIEW 987.62 <br /> TOTAL 987.62 <br /> FIELDSTONE FAMILY HOMES Payment(s) <br /> 801 CLIFF RD E CHECK 6242 987.62 <br /> SUITE 135 <br /> BURNSVILLE,MN 55337- <br /> (952)469-8800 <br /> Minnesota State License#: BUIL-BC631164 <br /> OWNER <br /> Fieldstone Family Homes <br /> 801 CLIFF RD E <br /> SU[TE 135 <br /> BURNSVILLE, MN 55337- <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 onty 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 permit may be /,� � <br /> revoked at any time for due cause. � / I` <br /> - . � . <br /> •, <br /> - _ =-�. i 2�`3�� ���' ��,��_� ����.�� ������ ,���- �, ��-_-_ <br /> Applicant Permitee Signatare Date Issued By Signature " Date <br />