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CITY OF ORONO 11111111111111111111111111 111111111111111111111111111 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/07/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4490 WATERTOWN RD <br /> PIN : 31-118-23-21-0005 <br /> LEGAL DESC : N/A <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 14,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 14000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2013-00464 <br /> APPLICANT ADVANCED PLAN REVIEW 162.99 <br /> CHELBERG, GLEN&MICHAELA TOTAL 162.99 <br /> 4490 WATERTOWN RD <br /> MAPLE PLAIN,MN 55359 PAID WITH CC# 4417 <br /> OWNER <br /> CHELBERG, GLEN&MICHAELA <br /> 4490 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 governing 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 at any ti s- for due cause. <br /> 6 / 7 / / <br /> Applicant Permit- •nature Date Issued B,/.ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OT ,r• THAN DESCRIBED AB(itE. <br />