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1 '�� <br /> CITY OF ORONO PERMIT NO.: 2009-00413 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUED: 07/16/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 785 FERNDALE RD N <br /> PIN : 36-118-23-ll-0012 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1031 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> NOT�: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT: $ 20,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADV. PL,AN REVIEW FOR POOL BUILDING <br /> PERMIT#THIS PRE-PAYMENT IS T[ED TO:2009-00414 <br /> APPLICANT ADVANCED PLAN REVIEW 220.51 <br /> JR, MICHELLE&THOMAS CULLUM TOTA1, 220.51 <br /> 785 FERNDALE RD N <br /> WAYZATA, MN 55391 <br /> OWNER <br /> JR, MICHELLE&THOMAS CULLUM <br /> 785 FERNDALE RD N ` ''�`` ' <br /> , }�N� J JJ.,-:..` , <br /> WAYZATA, MN 55391 <br /> r} :�h�: .. <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifica[ions,applicable City approvals,and the <br /> State Building Code. 7�his permit is for only the work described and does ��1'''� <br /> no[ rant ermission for additional or related work which re uires se arate �3' �_' <br /> g p 9 P ��--� �*; <br /> 3't.,.. <br /> permits. All provisions of laws and ordinances governing this type of work ��,�hi�� <br /> shall be compied with whether or not specified herein.This permit will � ' <br /> expire and become null and void if construction authorized is noi y + <br /> commenced within 180 days of the date of issuance,or if construction is _c_,__._. <br /> suspended for a period of(80 days at any[ime after work has commenced. , <br /> The applicant is responsible for assuring all required inspections are n1; j�7; '�t� :; <br /> requested in conformance with the State Building Code.This permit may be �r; <br /> revoked at any time for due cause. ' <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />