HomeMy WebLinkAbout2017-01516 - interior remodel CITY OF ORONO *IIIZ 0 ill 71� _I I �5 6 11*
2750 KELLEY PARKWAY DATE ISSUED: 11/16/2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4160 FOREST LAKE DR
PIN : 07-117-23-11-0003
LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN
: LOT 004 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 35,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$35,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: INTERIOR REMODEL
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-01517
APPLICANT ADVANCED PLAN REVIEW 355.27
CLINE,JUSTIN&HOLLY TOTAL 355.27
Payment(s)
4160 FOREST LAKE DR CHECK 2486 355.27
MOUND,MN 55364-
OWNER
CLINE,JUSTIN&HOLLY
4160 FOREST LAKE DR
MOUND,MN 55364-
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 Date Issued By ature Date