HomeMy WebLinkAbout2015-01429 - adv plan review t �
CITY OF ORONO * 2 0 1 5 - PJ 1 4 2 9 *
2750 KELLEY PARKWAY DATE ISSUED: l U05/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 4645 ST.ANDREWS ST
PIN : T000121
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 14 BLOCK 3
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 950,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$950,000
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW I-IOUSE
PERMIT#THIS PR�PAYMENT IS TIED TO:2015-01430
APPLICANT ADVANCED PLAN REVIEW 3,894.86
TOTAL 3,894.86
SWANSON HOMES Payment(s)
1360 HAMEL ROAD CHECK 35924 3,894.86
MEDINA,MN 55340-
(763)478-0320
Minnesota State License#: BUIL-627982
OWNER
Source Land Development Inc.
18215 45TH AVE N
STE D
PLYMOUTH,MN 55446-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit is issued shall be performed according to
the approved ptans 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 sepazate
permits. All provisions of laws and ordinances goveming this type 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 consuuction 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
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� North American Benkin Compeny
S�Ufllk71J11 1360 Hamel Ftosd WoodDur,MI� A
Medlna,MN 55340
MOM�!i 75-��'3-9� �
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� November 05, 2015 $3,894.$6 E
� DA7E AMOUNT
� �Y Three Thousand Eight Hundred Ninety-Four 8�86/100 Dollars
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� City of Orono �
� 2750 Kelley Parkway � easF
TO THE Orono, MN 55356 .��°p r`�F
I ORDER OF �_ M_� �.r�� �J��.
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ii'0359 24�i' �:0960 i6930�: i80 20057i�'
CURT SWANSON HOMES,LLC 3 5 9 2 4
Memo:
Check 35924 November 05,2015 City of Orono $3,894.86
Number of Invoices 1
Invoice Number Desc�iption Date Amount Paid Disc
4645 4645 St.Andrews$treet 11/5/2015 $3,894.86 $3,894.86