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� . CITY OF ORONO * z 0 1 z - 0 1 a 5 3 * <br /> � � � 2750 KELLEY PARKWAY DATE ISSUED: 10/19/2012 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> REPRINTED ON 10/19/2012 <br /> ADDRESS : 3400 NORTH SHORE DR <br /> PIN : 08-117-23-43-0016 <br /> LEGAL DESC : LYDIARDS PARK LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMTT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 150,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$150000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-01054 <br /> APPLICANT ADVANCED PLAN REVIEW 881.89 <br /> Southwestern Capital LLC TOTAL 881.89 <br /> 3400 NORTH SHORE DR <br /> WAYZATA,MN 55391- <br /> Minnesota State License#: 1206 <br /> OWNER <br /> Southwestern Capital LLC <br /> 3400 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 sepazate <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 /> 1'he 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 /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />