HomeMy WebLinkAbout2013-00556 - adv plan review CITYOFOR NO * 2013 - 00556 *
2750 KELLEY PAR WAY DATE ISSUED: 06/24/2013
ORONO, MN 55 56-
(952) 249-4600 FAX: (9 ) 249-4616
ADDRESS : 4185 BAYSIDE RD
PIN : 06-117-23-14-0012
LEGAL DESC : NORTH ARM ESTATES 3RD ADDN
: LOT 002 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 8,200.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT: $8200.00
TYPE OF PERMIT THIS PAYMENT IS FOR: SHED
PERMIT#THIS PRE-PAYMENT[S'CIED"CO: 2013-00557
APPLICANT ADVANC D PLAN REVIEW 115.05
CROWN CONSTRUCTION TOTAL 115.05
5249 GOLDEN VALLEY RD
GOLDEN VALLEY, MN 55427- PAID ITH CC# 3291
(612) 868-1899
Minnesota State License#: BC450383
OWNER
REZABEK, ALLAN & SHIRLEY
4185 BAYSIDE RD
MAPLE PLAIN, MN 55359-
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 l80 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 a[any time for due cause.
/ / / /
Applicant Permitee Signatnre Date Issued y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTH R THAN DESCRIBED ABOVE.