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CITY OF ORONO * 2 0 1 7 - 0 0 6 6 7 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 06/19/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3188 NORTH SHORE DR <br /> PIN : 09-117-23-32-0011 <br /> LEGAL DESC : CRYSTAL BAY PARK <br /> : LOT 000 BLOCK 004 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 16,500.00 <br /> NOTE: PLEASE FILL M THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 16,500.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: POOL HOUSE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00668 <br /> APPLICANT ADVANCED PLAN REVIEW 201.34 <br /> TOTAL 201.34 <br /> RUCINSKI,MICHEAL&HOLLY Payment(s) <br /> 3188 NORTH SHORE DR CHECK 5117 201.34 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> RUCMSKI,MICHEAL&HOLLY <br /> 3188 NORTH SHORE DR <br /> WAYZATA,MN 55391- <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 governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become nul►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 />