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CITY OF ORONO * 20 1 4 - 0 1 382 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/26/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 625 FERNDALE RD N <br /> PIN : 36-118-23-11-0021 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 250,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 250,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: INTERIOR REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2014-01383 <br /> APPLICANT ADVANCED PLAN REVIEW 1,271.89 <br /> TOTAL 1,271.89 <br /> LECY BROS HOMES Payment(s) <br /> 15012 HWY 7 CHECK 40047 1,271.89 <br /> MINNETONKA, MN 55345- <br /> (952)944-9499 <br /> Minnesota State License#: BUIL-20325555 <br /> OWNER <br /> GLAD, CARSON&KAROLIEN <br /> 625 FERNDALE RD N <br /> WAYZATA, MN 55391- <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 time r due cause. <br /> ‘776//-67‘ (_ C C C('/X <br /> Applicant 'ermitee Signature Date Issued By Signature Date <br />