HomeMy WebLinkAbout2016-01057 - mud room CITY OF ORONO * 2 0 1 6 - 0 1 0 5 7 *
2750 KELLEY PARKWAY DATE ISSUED: 08/30/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 4640 NORTH ARM DR W
PIN : 06-117-23-23-0005
LEGAL DESC : LJNPLATTED 06 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 28,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 28,000
TYPE OF PERMIT THIS PAYMENT IS FOR: MUD ROOM
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01O5�R
APPLICANT ADVANCED PLAN REVIEW 303.90
TOTAL 303.90
A.M.BURNEY EXTERIORS,INC. Payment(s)
14367 78TH STREET NE CHECK 2061 303.90
OTSEGO,MN 55330-
(952)836-8938
Minnesota State License#:BUIL-BC635734
OWNER
IVERSON,DANIEL&LINDA
4640 NORTH ARM DR W
MOLJND,MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of Iaws and ordinances goveming this type of work
shall be compied with whether or not specified hereia This permit will
expire and become null and void if construction authorized is not
commenced within l80 days of the date of issuance,or if construction is
suspended for a period of 180 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.
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Applicant Permitee Signature Date Issued By Signature Date