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CITY OF ORONO * Z 0 1 S — 0 0 5 6 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/1 U2015 <br /> . � '` ORONO, MN 55356— <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 517 FERNDALE RD N <br /> PIN : 36-ll 8-23-14-0007 <br /> LEGAL DESC : LJNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�TSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 15,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$15,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: IN GROUND POOL <br /> PERMIT#TH[S PRE-PAYMENT IS TIED TO:2015-00564 <br /> APPLICA1vT ADVANCED PLAN REVIEW 181.23 <br /> TOTAL 181.23 <br /> PERFORMANCE POOL& SPA Payment(s) <br /> 2405 ANNAPOLIS CHECK 1328 181.23 <br /> PLYMOUTH,MN 55441- <br /> (651)731-3940 <br /> OWNER i;i ry or Ur�ono <br /> �150 Keiley�Pa�kway g�2-249-4EU0 <br /> BURNET, RALPH& PEGGY Orono MN �53�6 <br /> 392 FERNDALE RD Receipt No: ;3.013364 May 11. 2U15 <br /> WAYZATA, MN 55391- <br /> Performance Pool & Spa <br /> Previ�us Balance: •��� <br /> AGREEMENT AND SWORN STATEMENT F'ermits 18� �•3 <br /> 2015-OU565 517 Ferndale <br /> The work for which this permit is issued shall be performed according to Rd N <br /> the approved plans and specifications,applicable City approvals,and the 101-34410 <br /> Plan Check/Site Exam Fees _ <br /> State Building Code. This permit is for only the work described and does 181.23 <br /> not grant permission for additional or related work which requires separate TDta 1: _______________ <br /> permits. All provisions of laws and ordinances goveming this type of work � � <br /> shall be com ied with whether or not s ecified herein.This ermit will CheGk , <br /> expire and become null and void if conPtruction authorized p not Check No: 1328 181.�_3 <br /> commenced within 180 da s of the date of issuance,or if construction is Pdyor' <br /> sus ended for a eriod of 80 da s at an time after work has commenced. f'�r f���r�t��O1��� Pool & Spa ��� �� <br /> p p Y Y lotal ApF�lie��l: _ <br /> The applicant is cesponsible for assuring all requiced inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revok at ime o ue cause. �� <br /> L� <br /> �� � <br /> � S�� 1�� L.�—�.� �`l'V`�-`b � � �- ((� -- <br /> Applicant Permitee Signature � Date Issued By Signature Date <br />