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CITY OF ORONO * z 0 1 2 - 0 a 6 7 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 0'7/16/2012 <br /> ' ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> � <br /> ADDRESS : 1376 PARK DR <br /> PIN : 07-117-23-41-0096 <br /> LEGAL DESC : SAGA HILL REVISED,HENNEPIN CO <br /> : LOT MB BLOCK 013 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 6,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 6,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: STOOP OFF HOUSE&WALKWAY <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00671 <br /> APPLICANT ADVANCED PLAN REVIEW 86.29 <br /> LARSON&TERESA,DAYTON TOTAL 86.29 <br /> 1376 PARK DR <br /> MOLTND,MN 55364- PAID WITH CC# 8064 <br /> OWNER <br /> LARSON&TERESA,DAYTON <br /> 1376 PARK DR <br /> MOLJND,MN 55364- <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 rela[ed 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 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 />