HomeMy WebLinkAbout2011-00865 - adv plan review CITY OF ORONO PERMIT NO.: 2011-00865
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssUEu: 08/15/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 930 COX FARM RD
PIN : 27-118-23-33-0013
LEGAL DESC : SHADOWOOD FARM
: LOT O10 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REV[EW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 400,000.00
NOTE: PLEASE FILL IN TEIE FOLLOWING:
VALUATION OF PERMIT:$ 400,000.00
TYPE OF PF,RMI"I�THIS PAYMENT IS FOR: REMODEL
PERMIT#THIS PRE-PAYMENT IS TIED TO:2011-00866
APPLICANT ADVANCED PLAN REVIEW 1,856.89
VIKING CONSTRUCTION, WC. TOTAL 1,856.89
871 JEFFERSON AVE.
ST.PAUL, MN 55102- PAID WITH CC# 0251
(651)222-3065
Minnesota State License#: 20332522
OWNER
KILLINGSTAD, MR. &�
930 COX FARM RD
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEMENT
Thc work for which this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for oniy the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and bccome null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construc[ion is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsibl assuring all required inspections are
requested in conforma ith[he State Building Code.This permit may be
revoke or due cause.
o�' �� - � � �/l�.S' l�� (;�9/ZyC.�-� l l
Applicant,�ermitec Signal�re Date Issued By S' ature Date
/ - SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB .