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• � � CITY OF ORONO * 2 0 1 z - 0 1 z 0 2 * <br /> ' ' 2750 KELLEY PARKWAY DATE ISSUED: 1U28/2012 <br /> ORONO, MN 55356- <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 /> CONSTRUCTIOIV TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 8,400.00 <br /> NO'1'F,: PLEASE FILL IN T}IE FOLLOWING: <br /> VALUATION OF PERMIT: $ $ 8400.00 <br /> TYPE OF PERMIT THIS PAYMENT[S POR: BUILD[NG PGRMI"I' <br /> PGRMIT#"I�HIS PRE-PAYMENT IS"1'IGD TO:2012-01203 <br /> APPL[CANT ADVANCED PLAN REVIEW I 15.05 <br /> VAN HEEL CONSTRUCTION, INC. TOTAL 1 15.05 <br /> 2375 ORKLA DR. <br /> GOLDEN VALLEY, MN 55427 <br /> (763)438-9920 <br /> Minnesota State License#: BC001592 <br /> OWNER <br /> WOTIPKA, 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 issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> Statc l3uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or related�vork 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 pennit will <br /> expire and become null and void if construction authorized is not <br /> commenced�vithin 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time aftcr work has commenced. <br /> I�he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked t any time for d e causc. <br /> � / i Z8 i Z01Z � � <br /> A plicant �rmitee S gnature Date Issued By �nature Date <br /> SEPARA�I'F, PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />