HomeMy WebLinkAbout2017-00019 - adv plan review CITY OF ORONO * 2 0 1 7 - 0 0 0 1 9 *
2750 KELLEY PARKWAY DATE ISSUED: OU10/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2800 SHADYWOOD RD
PIN : 21-117-23-13-0023
LEGAL DESC : REG. LAND SURVEY NO. 1196
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CO1vSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 500,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$500,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOUSE
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00020
APPLICANT ADVANCED PLAN REVIEW 2,359.45
TOTAL 2,359.45
CREEK HILL CUSTOM HOMES Payment(s)
15235 65TH PL N CREDIT CARD 8936 2,359.45
MAPLE GROVE,MN 55311-
(763)553-0325
Minnesota State License#: BUIL-20415174
OWNER
BERGH,HANS&SHARON
2800 SHADYWOOD RD
EXCELSIOR,MN 55331-
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 dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this rype of work
shalâ–ºbe 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.
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Applicant Permitee Signature Date Issued By Signature Date