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CITY OF ORONO PERMIT NO.: 20��-ooso2 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 5535(- DATE ISSUED: 08/04/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2740 KELLY AVE <br /> PIN : 21-117-23-23-0037 <br /> LEGAL DESC : VERN-MAR MANOR <br /> : LOT 012 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 82,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$82,000 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: 2011-00803 <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:GARAGE ADDITION <br /> APPLICANT ADVANCED PLAN REVIEW 599.14 <br /> AUTUMN RIDGE HOMES INC TOTAL 599.14 <br /> POBOX375 <br /> DELANO,MN 5532& <br /> (763)269-2697 <br /> Minnesota State License#:20637701 <br /> OWNER <br /> O'MALLEY,PHYLLIS <br /> 2740 KELLY AVE <br /> EXCELSIOR,MN 55331- <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 permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <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 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 Perrnitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THANDESCRIBED ABOVE. <br />