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CITY OF ORONC� * Z 0 1 3 - 0 0 0 0 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: O1/04/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> REPRIN"rED ON 1/4/2013 <br /> ADDRESS : 495 OXFORD RD <br /> PIN : OS-I17-23-41-0011 <br /> LEGAL DESC : STIELOWS ADDN <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 1,150,000.00 <br /> NOTE: PLEASG FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT: $ 1,150,00Q00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW I IOME <br /> YERMI"I'#TH[S PRGPnYMGNT IS�l'IED"I�(>:2013-00007 <br /> PLAN REVIEW PD ORIGINALLY ON PERMIT 2012-00639$5153.69. NEW PLAN REVIEW FEE IS$4261.89. DIFFERENCE OF 891.80 TO <br /> BE CREDITED TO BUILDING PERMIT FEF,. <br /> APPLICANT ADVANCED PLAN REVIEW 4,261.89 <br /> STONEWOOD, LLC TOTAL 4,261.89 <br /> 7407 WAYZATA BLVD <br /> MINNEAPOLIS, MN 55426- 4,261.89 <br /> (952)697-5590 �Q�� <br /> Minnesota State License#: 20594315 a�D/a-OD(o'.�� <br /> OWNER <br /> SAMPLE, MIKE&ANNE <br /> 1449 BAY RIDGE RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd 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 widiin 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter 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 13y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />