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CITY OF ORONO * Z 0 1 2 — 0 B 9 5 5 * <br /> " 2750 KELLEY PARKWAY DATE ISSUED: 09/25/2012 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3520 NORTH SHORE DR <br /> PIN : 08-117-23-43-0009 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 243,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 243,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00956 <br /> APPLICANT ADVANCED PLAN REVIEW 1,244.59 <br /> ROBERTS RESIDENTIAL REMOD INC. <br /> 2999 W CTY RD.42-#100 TOTAL 1,244.59 <br /> BURNSVILLE,MN 55306- Cit of Orono <br /> (952)224-3680 ����ey p�Y y��49� <br /> Minnesota State License#:BC006885 <br /> Reeeipt No: 3.007fi79 5ep 25, P012 <br /> OWNER <br /> PETERS ET AL,ANN L Roberts ttesidential R�odeling <br /> 3520 NORTH SHORE DR Previous Balar�e: .40 <br /> ,MN 55391- Pereit5 <br /> 201�-00955 3520 North 1,244.59 <br /> Share Dr <br /> 141-34410 <br /> AGREEMENT AND SWORN STATEMENT Plan Check/Site Exa� Fees <br /> The work for which this permit is issued shall be performed according to Tatal S 1�244.`J9 <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 (��k <br /> not grant permission for additional or related work which requires sepazate (�12Ck �; i� 1�2�.S9 <br /> permits. All provisions of laws and ordinances governing this type of work payppp <br /> shall be compied with whether or not specified herein.This permit will Roberts Resident ial Re�odel ing <br /> expire and become null and void if construction authorized is not Tatal Applied: I�244.59 <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. aldfl� TBTId21"2d C .I� <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be �����12 ��� <br /> o e at any time for du ause. /(f!/ <br /> /�? � c-�n� � i �i �S -/ <br /> Applican ermitee Signatur Date Issued By Sig ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />