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CITY OF ORONO * 2 0 1 5 — 0 0 3 5 1 * <br /> ,r 2750 KELLEY PARKWAY DATE ISSUED: 03/27/2015 <br /> ORONO,MN 55356- <br /> - 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4215 NORTH SHORE DR <br /> PIN : 07-117-23-43-0006 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 80,000.00 <br /> NOTE: PLEASE FILL IN TI-IE FOLLOWING: <br /> VALUATION OF PERMIT:$ 80,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: KITCHEN REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-00353 <br /> APPLICANT ADVANCED PLAN REVIEW 618.96 <br /> MALESKA CUSTOM BUILDERS TOTAL 618.96 <br /> Payment(s) <br /> 10282 HAWTHRONE RD NW CREDIT CARD 4031 618.96 <br /> RICE,MN 56367- <br /> (320)251-7898 <br /> Minnesota State License#:BUIL-BC 109531 <br /> OWNER <br /> WALDOCH,DOUGLAS&DIANE <br /> 4215 NORTH SHORE DR <br /> MOUND,NIN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shatl 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.l'his permit will <br /> e�cpire 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 B ignature Date <br />