HomeMy WebLinkAbout2009-00634 - adv plan review � CITY OF ORONO PERMIT NO.: 2009-00634
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/25/2009
952 249-4600 FAX: 952 249-4616
REPRINTED ON 9/25/2009
ADDRESS : 965 EDGEWOOD H[LLS RD
PIN : 02-117-23-]4-0001
LEGAL DESC : REG. LAND SURVEY NO. 1098
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT: $ 263,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION
PERMI'I'#THIS PRE-PAYMENT IS TIED TO: 2009-00635
APPLICANT ADVANCED PLAN REVIEW 1,322.59
JAMES PATSCH CONST INC. TOTAL 1,322.59
3427 HUMBOLT AVENUE S
MINNEAPOLIS, MN 55408
(612)527-0111
Minnesota State License#: 4290
OWNER
CUSICK, MR. & MRS. THOMAS
965 EDGEWOOD HILLS RD
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
Statc[3uilding Code. This permit is for only the work described and does
not gran[permission for additional or related work which requires separa[e
permits. All provisions of laws and ordinances goveming this type of wark
shall be compied with whe[her 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 aRer work has commenced.
The applicant is responsible for assuring alI required inspections aze
requested in conformance with the Sta[e Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.