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,� CITY OF ORONO PERMIT NO.: 2011-00776 <br /> � � 2750 KELLEY PARKWAY <br /> -�` ORONO, MN 55356- DATE �SSVEn: 08/02/20ll <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1205 DICKENSON ST <br /> PIN : 02-117-23-31-0040 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK 016 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 105,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERM[T: $ 105,000.00 <br /> TYPE OF PERMIT TFIIS PAYMENT IS FOR: BUILDING <br /> PERMIT#7'1 IIS PRE-PAYMENT IS TIED TO:201 1-00777 <br /> APPLICANT ADVANCED PLAN REVIEW 706.39 <br /> VAN HEEL CONSTRUCT[ON, INC. TOTAL 706.39 <br /> 2375 ORKLA DR. <br /> GOLDEN VALLEY, MN 55427 PAID WITH CC# 1270 <br /> �) <br /> Minnesota State License#: 1592 <br /> OWNER <br /> WOT[PKA, LINDA A& LEE A <br /> 9908 N W 20TH ST <br /> PEMBROKE PINES,FL 33024- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <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 <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsiblc for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked a[any �me for due caus <br /> � _� ;� �i / � 1 <br /> `- `{ / / <br /> Applic�nt Perrnit e Signat� re Date <br /> _ � Issued By S'g ature Date <br /> � SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />