HomeMy WebLinkAbout2017-00360 - advance plan review fee CITY OF ORONO * 2 pJ 1 7 - 0 0 3 6 0 *
2750 KELLEY PARKWAY DATE ISSUED: 04/14/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 797 BRIDGEWATER DR
PIN : 33-118-23-12-0021
LEGAL DESC : STONEBAY FOURTH ADDITION
: LOT O10 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 350,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 350,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW TOWNHOUSE
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00361
APPLICANT ADVANCED PLAN REVIEW 1,745.20
WOODDALE BUILDERS INC. TOTAL 1,745.20
6117 BLUE CR DR Payment(s)
MINNETONKA,MN 55343- CHECK 86906 1,745.20
(952)345-0543
Minnesota State License#:BUIL-BC002926
OWNER
Stonebrook Development LLC
17149 LINCOLN ST NE
#600
HAM LAKE,MN 55304-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and the
State Building Code. This perrr►it is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this rype of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of I80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ /
Applicant Permitee Signature Date Issued By Sigr►ature Date
' ' ' MIDWESTONE BANK
,� �-,�� 86906
` 6117 Blue Circle Drive,Suite 101
WOODDALE ►winneto�ca,MN 55343
B � ' ` ° E " g (952)345-0543-(952)345-0544
pay; **************One thousand seven hundred forty-five dollars and 20 cents
DATE CNECK NO. ANtOIiNT
April 13, 2017 86906 $******1,745.20
PAY
TOTHE City of Orono
oROER PO Box b 6 I
°F Crystal Bay, MN 55323-0066
�,�,���