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CITY OF ORONO * 2 0 1 6 - 0 0 5 5 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/20/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 145 MANOR CIR <br /> PIN : 04-117-23-11-0024 <br /> LEGAL DESC : COUNTRYSIDE MANOR 3RD ADDITION <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 38,350.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 38,350.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION OVER GARAGE <br /> PERMIT#THIS PRE-PAYMENT IS TIED T02016-00558 <br /> APPLICANT ADVANCED PLAN REVIEW 384.62 <br /> WILLETTE BUILDING CO. TOTAL 384.62 <br /> 6074 COUNTY RD 6 Payment(s) <br /> MAPLE PLAIN,MN 55359- CHECK 1064 384.62 <br /> (952)472-4332 <br /> Minnesota State License#:BUIL-1804 <br /> OWNER <br /> NAFSTAD,ADAM&KRISTIN <br /> 145 MANOR CIR <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued sha(I 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 additiona(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 /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />