HomeMy WebLinkAbout2013-01068 - adv plan review CITY OF ORONO * 2 PJ 1 3 - 0 1 0 6 B *
2750 KELLEY PARKWAY DATE ISSUED: 10/10/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2650 COUNTRYSIDE DR W
PIN : 04-ll 7-23-12-OO14
LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN
: LOT 006 BLOCK 002
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 31,500.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 31,500.00
TYPE OF PERMIT THIS PAYMENT IS FOR: POOL PERMIT
PERMIT#THIS PRE-PAYMENT IS TIED T0:2013-01069
APPLICANT ADVANCED PLAN REVIEW 317.36
PETERSON POOLS& SPAS INC. TOTAL 31736
13]]0 EXCELSIOR BLVD
MINNETONKA, MN 55343-
(952)933-3010
OWNER
JORGENSON, ROBERT
2650 COUNTRYSIDE DR W
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEMENT
The work Sor which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciri 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 assurin�all required inspections are
requested in con rmance with the State Building Code.This permit may be
revoked at an� �me for due c
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A p nt Permit e Signature Date Issued By S' ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABOVE