HomeMy WebLinkAboutJOB CANCELLED-2010-00260 r �
CITY OF ORONO PERMIT NO.: 2010-00260
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuEn: 04/26/2010
952 249-4600 FAX: 952 249-4616
PRINTED WITHOUT ISSUING 5/11/2010
ADDRESS : 1795 SHADYWOOD RD
PIN : 17-117-23-21-0008
LEGAL DESC : REG. LAND SURVEY NO. 0702
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 15,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 15,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: DECK ITION
PERMIT#THIS PRE-PAYMENT IS TIED TO: 2 0.00261
TOTAL AMOLINT OF$172.58 WILL BE REFUN D-JOB CANCELLED
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APPLICANT ADVANCED PLAN REVIEW 172.58
BETZ BUILDERS INC. TOTAL 172.58
300 CRESTVIEW AVE.
LONG LAKE,MN 55356
(612)221-2963
OWNER
DIERCKS, MICHAELA
1795 SHADYWOOD RD
P.O. BOX 81(NAVARRE
WAYZATA, MN
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not speciYied hecein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring aIl required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
. �
TO: Peter Zimmerman
FROM: Monica Fadness, Administrative Asst.
SUBJECT: Refund
DATE: May 11, 2010
A building permit for 1795 Shdaywood Road has been cancelled. The plan review fee
was paid in advance for this building permit. I am requesting a refund in the amount of
$172.58 made payable to: Betz Builders Inc.
Please mail the check to: Betz Builders Inc.
300 Crestview Avenue
Long Lake, MN 55356
Thank you.