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� � CITY OF ORONO PERMIT NO.: 20ll-00990 <br /> 2750 KELLEY PARKWAY <br /> ' ORONO, MN 55356- �ATE ISSUED: 09/OU2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1635 BOHNS POINT RD <br /> PIN : 17-117-23-11-0006 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0565 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REV[EW <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 RGMODEL&CHANGE ROOF PITCH <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO: 20 1 1-0099 1 <br /> APPLICANT ADVANCED PLAN REVIEW 1,271.89 <br /> TIMBERLAND BUILDERS <br /> 17641 CASCADE DR 1,271.89 <br /> ._ �. ."r�' -'n�' <br /> EDEN PRAIRIE, MN 55347 ;;no 'MFI �5S3.5f <br /> (612)909-0663 <br /> Minnesota State License#:20135484 <br /> OWNER <br /> KOZLAK, STNICK&JODEE "�j�'r�`• ��n';��' <br /> 1635 BOHNS PT RD �'��� <br /> :5.. <br /> WAYZATA,MN 55391- 4 Ru <br /> �t-��,� <br /> �;3Tt . <br /> AGREEMENT AND SWORN STATEMENT .tdl: <br /> The work for which this permit is issued shall be performed according to '+� bdi3YrL8: y c i.t,:. <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 �.-� Nq; 15b29 lr c'�� <br /> not grant permission for additional or rclated work which requires separate -��,� <br /> permits. All provisions of laws and ordinances governing this type ofwork ;;�rland Aui lder'Sw I1it. <br /> shall be compied with whether or not specified herein.This permit will {��pi�o�j; 1a�j;.,'. <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 ���j; ,�� <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 � O1/;-'_l1;i ���:�n�' <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due ause. , •� ��IJi <br /> k f/� ��L "l1L� C"�-/L�/ ��r CC ���'Y1C i�1 � � //. // <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />