HomeMy WebLinkAbout2012-00827 - adv plan review � CITY OF ORONO * z 0 1 2 - 0 0 B z 7 *
2750 KELLEY PARKWAY DATE ISSUED: 08/22/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1910 SHORELINE DR
PIN : 10-117-23-42-0017
LEGAL DESC : REG.LAND SURVEY NO.0096
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 1,250,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 1,250,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW SINGLE FAMILY HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00828
APPLICANT ADVANCED PLAN REVIEW 4,521.89
SMUCKLER CUSTOM BUILDERS,INC. TOTAL 4,521.89
7509 WASHINGTON AVE.S.
EDINA,MN 55439- PAID WITH CC# 1632
(952)828-1908
Minnesota State License#:20384253
OWNER
&H MOUSAVINASAB,MAJID FEHRESTI
i910 SHORELINE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
th: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 speeified 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 aze
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.