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CITY OF ORONO PERMIT NO.: 2009-00613 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssUEn: 09/22/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1995 FOX R[DGE RD <br /> PIN : 03-117-23-13-0005 <br /> LEGAL DESC : FOX RIDGE <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT: $ 2800.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT <br /> PERMIT#THIS PKE-PAYMENT IS T[ED TO:2009-0061� <br /> APPLICANT ADVANCED PLAN REVIEW 57.53 <br /> KIELEY, THOMAS TOTAL 57.53 <br /> 1995 FOX RIDGE RD <br /> LONG LAKE, MN 55356 PAID WITH CASH 57.53 <br /> OWNER <br /> KIELEY, THOMAS <br /> 1995 FOX RIDGE RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMEIVT <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. ��his 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 goveming 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 l80 days of the date of issuance,or if consVuction is <br /> suspended for a period of 180 days a[any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ��2 ���'�i'"_��� . � � l l <br /> Applicant Per itee Signature Date Issue By � ature te <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER AN DESCRIBED ABO <br />