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CITY OF ORONO * 2 0 1 z - a 0 7 B 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/13/2012 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2755 KELLY AVE <br /> PIIv : 21-117-23-23-0026 <br /> LEGAL DESC : REG.LAND SURVEY NO.0891 <br /> : LOT 000 BLOCK 000 <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 1N THE FOLLOWING: <br /> VALUATION OF PERMIT:$5,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR:BUILDING PERMIT FOR DECK REPLACEMENT <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00787 <br /> APPLICANT ADVANCED PLAN REVIEW 76.70 <br /> LOCAL LAKES CONSTRUCTION TOTAL 76.70 <br /> 445 NIAGARA LANE N <br /> PLYMOUTH,MN 55447- PAID WITH CC# 3044 <br /> (612)418-4478 <br /> Minnesota State License#: BC473986 <br /> OWNER <br /> KAVERMAN-GESELL,DREW GESELL&K <br /> 2755 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 Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />