HomeMy WebLinkAbout2013 - 01279 - adv plan review CITY OF ORONO l f 1 III1HHI II III zI QI III
2750 KELLEY PARKWAY DATE ISSUED: 12/10/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2120 WAYZATA BLVD W
PIN : 34-118-23-24-0001
LEGAL DESC : UNPLATTED 34 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 3,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT: $ $3000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT
PERMIT#THIS PRE-PAYMENT IS TIED TO:2013-01280
APPLICANT ADVANCED PLAN REVIEW 57.53
ERICKSON,BRAD TOTAL 57.53
Payment(s)
2486 BOBOLINK RD
CHECK 8334 57.53
MEDINA, MN 55356-
(612)490-2371
OWNER
ERICKSON, BRAD
2486 BOBOLINK RD
MEDINA,MN 55356-
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 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 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 Da e Issued By gnature Date