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CITY OF ORONO PERMIT NO.: 2010-00621 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 07/26/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4295 WATERTOWN RD <br /> PIN : 31-118-23-13-0004 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> .VALUATION : $ 8,500.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 8500.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2010-00622 <br /> APPLICANT ADVANCED PLAN REVIEW 115.05 <br /> TWO TEACHER CONSTRUCTION TOTAL 115.05 <br /> 2586 AVON DR <br /> MOUND,MN 55364 PAID WITH CC# 3619 <br /> (612)598-2191 <br /> Minnesota State License#:20073200 <br /> OWNER <br /> KANG,RAYMOND&KIMBERLY <br /> 4295 WATERTOWN RD <br /> MAPLE PLAIN,MN 55359 <br /> AGREEMENT AND SWORN STATEMENT <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 <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <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 <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked y ' e for due cause. <br /> fir fr -7 / Z6 / 10 s. 1 // --Il/cat--"K / / <br /> Applican ,a''ermitee Signature Date Issued By `i ature ,�C Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO'V . <br />