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` � CITY OF ORONO <br /> * 2 0 1 6 — 0 0 5 6 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/23/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1 135 HERITAGE LA <br /> PIN : 10-117-23-13-0021 <br /> LEGAL DESC : FOXHILL <br /> : LOT 000 BLOCK 003 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 350,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$350,000.00 <br /> TYPE OF PERM[T THIS PAYMENT IS FOR: ADDITION <br /> PERMIT#THIS PRE-PAYMENT IS T[ED TO:2016-00571 <br /> APPLICANT ADVANCED PLAN REVIEW 1,745.20 <br /> TOTAL 1,745.20 <br /> HERMAN RENOVATION Payment(s) <br /> 5645 EUREKA RD. CHECK 17981 1,745.20 <br /> EXCELSIOR, MN 55331 <br /> (952)474-4757 , <br /> Minnesota State License#: BU[L-BC007107 <br /> i�rono MN ����.���; y�,z-�ay-�r�uu <br /> OWNER R�;ceipt No: .:.0156a0 May �3, 2i;1G <br /> MARKUSEN, LOCKIE <br /> 1135 HERITAGE LA Her�iriar� Rern.�v�tior� <br /> WAYZATA, MN 55391- <br /> I'��,vinus Balance: .�.��� <br /> Permits <br /> 2016-00565 �,745 2U <br /> AGREEMENT AND SWORN STATEMENT 101-34410 <br /> The work for which this permit is issued shall be performed according to P l�� ChOCk%`1 te E x8m Fees <br /> the approved plans and specifications,applicable City approvals,and the - - - <br /> State Building Code. This permit is for only the work described and does (��«i; 1,745.�U <br /> not grant permission for additional or related work which requires separate ---- - --- ----- <br /> — _—-- -- - <br /> permits. All provisions of la���s and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will CriBCk <br /> expire and become null and void if construction authorized is not Ch�Ck Nu: 17981 !,lG5_�U <br /> commenced within 180 days of the date of issuance,or if construction is F'ayoY: <br /> suspended for a period of 1SO days at any time after work has commenced. Narman Gon�y=+;�,r <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 /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />