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• CITY OF ORONO * z 0 1 5 - 0 0 1 1 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU23/2015 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 683 SANDSTONE CIR <br /> PIN : 33-118-23-11-0043 <br /> LEGAL DESC : STONEBAY <br /> : LOT 040 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 219,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 219,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOUSE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:201 5-001 1 5 <br /> APPLICANT ADVANCED PLAN REVIEW 1,208.54 <br /> TOTAL 1,208.54 <br /> STONEBAY BUILDERS LLC Payment(s) <br /> 14870 BROCKTON LANE CHECK 1kC6� 1,208.54 <br /> DAYTON, MN 55327- i � / � <br /> (612)363-4304 <br /> Minnesota State License#: BUIL-BC681308 <br /> OWNER <br /> City of Or��no <br /> Stonebay Builders LLC 2750 Kel ley Parkway <br /> 14870 BROCKTON LANE Orono MN 55356 952-249-46U0 <br /> DAYTON, MN 55327- Receipt No: 3.012674 Jan 23, 2015 <br /> Stonebay auilders <br /> AGREEMENT AND SWORN STATEMENT r revious Balance: •�� <br /> The work for which this permi[is issued shall be performed according to Pe rm i ts <br /> 2015-OG114 683 Sandstone 1,208.54 <br /> the approved plans and specifications,applicable City approvals,and the C 1 rC le <br /> State Building Code. This permit is for only the work described and does 101-34410 <br /> not grant permission for additional or related work which requires separate P 1 ar� Cher.klS i te Exain Fees <br /> permits. All provisions of laws and ordinances governing this type of work '" -" - <br /> ---�- <br /> shall be compied with whether or not specified herein.This permit will Total: 1,20$.54 <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 CheCk <br /> Cf�eck No: 1110 1,208.54 <br /> suspended for a period of 180 days at any time afrer work has commenced. Payor: <br /> The applicant is responsible for assuring all required inspections are Stoneba Bui lders <br /> requested in conformance with the 5tate Building Code.This permit may be � � , •-,-�;-a. 1 ��is'? �d <br /> revoked at any time for due cause. <br /> , ��:f iyr. I�'fl(7�'!"��- <br /> � � <br /> Applicant Permitee Signature Date [ssued By Signature Date <br />