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CITY OF ORONO * 2 0 1 2 - 0 1 2 1 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/04/2012 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3675 JACOBS MILL RD <br /> PIN : 32-118-23-24-0012 <br /> LEGAL DESC : JACOBS MILL <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 5,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 5,000 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: WARMING HOUSE/SHED <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-01217 <br /> APPLICANT ADVANCED PLAN REVIEW 76.70 <br /> AMENT,JEFFREY&KARI TOTAL 76.70 <br /> 3675 JACOBS MILL RD <br /> LONG LAKE,MN 55356 PAID WITH CC# 9237 <br /> OWNER <br /> AMENT,JEFFREY&KARI <br /> 3675 JACOBS MILL RD <br /> LONG LAKE,MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This pertnit 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 governing 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 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at 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 /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRII3ED ABOVE. <br />