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CITY OF ORONO PERMIT NO.: 2010.00335 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 05/12/2010 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2172 SHADYWOOD RD <br /> PIN : 17-117-23-42-0010 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 755,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$755,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT FOR NEW STRUCTURE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2010-00336 <br /> APPLICANT ADVANCED PLAN REVIEW 3,075.64 <br /> TRUE NORTH HOMES INC TOTAL 3,075.64 <br /> 410 LAKEVIEW AVENUE <br /> TONKA BAY,MN 55331- <br /> (612)281-2540 <br /> Minnesota State License#:20636839 <br /> C�i�:y of Orono <br /> OWNER 2750 Kelley Paria+ay <br /> DORE,STEVEN ��0 � �'�' �-2��� <br /> 8351 WEST 109TH STREET Receipt No: 3.002557 May 12, 2010 <br /> BLOOMINGTON,MN 55438- 5teve Dore <br /> AGREEMENT AND SWORN STATEMENT Per�it5 <br /> 2010-40335 2172 �adyNood 3,075.64 <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 iQi—�¢1Q <br /> State Building Code. This permit is for only the work described and does Plan Check/5ite Exas Fees <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 TOtdl: 3���J.�F <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 �F1ECk <br /> commenced within 180 days of the date of issuance,or if construction is �1ECk �0� 11� 3t��J.� <br /> suspended for a period of 180 days at any time after work has commenced. ����e <br /> The applicant is responsible for assuring all required inspections are Total Appl ied7 �0�`J.�! <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 />