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CITY OF ORONO * Z PJ 1 7 — PJ 0 5 0 5 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/15/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3760 NORTHERN AVE <br /> PIN : 17-117-23-34-0051 <br /> LEGAL DESC : SOUTHVIEW ESTATES <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 48,500.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 48,500.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ENTRY ADDITION <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00504 <br /> APPLICANT ADVANCED PLAN REVIEW 458.01 <br /> TOTAL 458.01 <br /> VANDEPUTTE,MARY Payment(s) <br /> 3760 NORTHERN AVE CREDIT CARD 8901 458.01 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> VANDEPUTTE,MARY <br /> 3760 NORTHERN AVE <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 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 re ible for assuring all required inspections are <br /> requested in pofformpdce with the State Building Code.This permit may be <br /> re 6y ti or due cause. <br /> O <br /> pplicant Permitee Signature Date Issued By Signature Date <br />