HomeMy WebLinkAbout2011-00020 - adv plan review CITY OF ORONO PERMIT NO.: 20��-00020
2750 KELLEY PARKWAY �
ORONO, MN 55356- DATE ISSUED: OU07/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2256 SHADYWOOD RD
PIN : 17-117-23-43-0125
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT 006 BLOCK 001
:' PERMIT TYPE : ADVANCED PLAN REVIEW
'.. PROPERTY TYPE : RESIDENTIAL
' CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
; VALUATION : $ 150,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 150,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION
PERMIT#THIS PRE-PAYMENT IS TIED TO:20 1 1-0002 1
APPLICANT ADVANCED PLAN REVIEW 881.89
SHORELINE BUILDERS TOTAL 881.89
2184 SHADYWOOD RD
WAYZATA,MN 55391- PAID WITH CC# 7736
(763)506-0629
Minnesota State License#:20630814
OWNER
DEHAVEN PETERSON, ELLEN
960 SHADY LA �
WAYZATA, MN 55391-
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 goveming this rype of work
shall be compied with whether or not specified herein.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 all 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 PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.