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CITY OF ORONO PERMIT NO.: 2011-00004 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUEn: OU04/2011 <br /> ' 952 249-4600 FAX: 952 249-4616 <br /> AL`�:JRESS : 3095 NORTH SHORE DR <br /> PIN : 09-117-23-32-0014 <br /> LEGAL DESC : REG.LAND SURVEY NO.0670 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 870,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 870,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO: BUILDING PERMIT 2011-00005 <br /> APPLICANT ADVANCED PLAN REVIEW 3,44939 <br /> ROBERT CRAIG HOMES INC. TOTAL 3,449.39 <br /> 464 2ND ST.#101 <br /> EXCELSIOR, MN 55331 PAID WITH CC# 4679 <br /> (952)470-6639 <br /> Minnesota State License#: 8846 <br /> OWNER <br /> SIME,MICHAEL&PAMELA <br /> 1592 MEDINA RD <br /> LONG LAKE, MN 55356- <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 /> 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 an e for due cause. <br /> •� <br /> � � � � ������ // / �.O/ <br /> Applicant Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />