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CITY OF ORONO PERMIT NO.: 2011-00411 <br /> ' � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/OU2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1100 MILLSTON RD <br /> � PIN : 10-117-23-14-OOU(5 <br /> ; LEGAL DESC : MILLSTON <br /> ' : LOT 000 BLOCK 000 <br /> � <br /> ;_PERMIT TYPE : ADVANCED PLAN REVIEW <br /> ; PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATTON : $ 185,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 185000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ACCESSORY STRUCTURE-SWIMMING POOL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:20 1 1-004 1 2 <br /> APPLICANT ADVANCED PLAN REVIEW 1,01839 <br /> OLYMPIC POOLS, INC. TOTAL 1,018.39 <br /> 135 S ATWOOD STREET <br /> SHAKOPEE,MN 55379 PAID WITH CC# 0696 <br /> (952)445-7779 <br /> Minnesota State License#:20458239 <br /> OWNER <br /> BURWELL,MR.&MRS.RODNEY <br /> 7901 XERXES AVE S <br /> BLOOMINGTON,MN 55431- <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 /> permiu. 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 onformance with the State Building Code.This permit may be <br /> revoked at time for au . <br /> - ` �D / t / 2.c'(•� <br /> / / <br /> _Ap li t rmi e S gnature Date Issue y S' ature Date <br /> i , SEPARATE PERMITS REQUIRED FOR WORK OTHER N DESCRIBED AB . <br /> r . <br />