HomeMy WebLinkAbout2013-00307 - new structure CITY OF ORONO * Z 0 1 3 - 0 0 3 0 7 *
2750 KELLEY PARKWAY DATE ISSUED: OS/02/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1105 FERNDALE RD W
PIN : 02-117-23-43-0033
LEGAL DESC : REG. LAND SURVEY NO. 0441
: LOT MB BLOCK MB
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 757,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 757000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW S"CRUCTURE
PERMI'1'#THIS PRE-PAYMENT IS"I�IED T0:2013-00308
APPLICANT ADVANCED PLAN REVIEW 3,082.14
LIND NELSON CONST INC.
3794 299TH AVE NW TOTAL 3,082.14
ISANTI, MN 55040 PAID WITH CC# 1955
(612)282-3006
Minnesota State License#: BC384640
OWNER
TRUWIT, CHIP
1105 FERNDALE RD W
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according ro
the approved plans and specifications,applicable City approvafs,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein."I'his permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date ot�issuance,or if construction is
suspended for a period of 180 days at any time afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Uate Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.