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j -� CITY OF ORONO * z 0 1 5 - 0 1 1 9 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2015 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 10 MYRTLEWOOD RD <br /> PIIY : 36-I 18-23-33-0009 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 1,400,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 1,4000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01198 <br /> APPLICANT ADVANCED PLAN REVIEW 5,157.48 <br /> TOTAL 5,157.48 <br /> CHAMBERLAIN FINE CUSTOM HOMES payment(s) <br /> 11578 CHAMBERLA[N CT CHECK 933 5,157.48 <br /> EDEN PRAIRIE,MN 55344- <br /> (952)649-7653 <br /> Minnesota State License#: BUIL-BC661410 <br /> OWNER <br /> Chamberlain Capital LLC <br /> 11578 CHAMBERLAIN CT <br /> EDEN PRAIRIE, MN 55344- <br /> AGREEMENT A1vD 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 /> 'Che applicant is responsible for assuring all required inspections are �� � <br /> rcquested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due ca�e. <br /> � <br /> v� �L�'�_.- ��'�� � ��-� S (`' / i � � � <br /> Applicant Permitee Signature Date Issued y Signatu Date <br />