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CITY OF ORONO * Z p� 1 5 — P1 0 9 2 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/23/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4205 NORTH SHORE DR <br /> PIN : 07-117-23-43-0004 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTMTY : 434-RESIDENTIAL <br /> VALUATION : $ 36,000.00 <br /> NOTE: PLEASE FILL IN TI�FOLLOWING: <br /> VALUATION OF PERMIT:$ 36,000 <br /> TYPE OF PERMIT THIS PAYIV�NT IS FOR: DECK <br /> PERMIT#THIS PR�PAYMENT IS TIED TO: 2015-00928 <br /> APPLICANT ADVANCED PLAN REVIEW 362.60 <br /> TOTAL 362.60 <br /> SCOTT STIFTER SAWDUST CONSTRUCTION payment(s) <br /> 1455 OXFORD AVE CREDIT CARD 0793 362.60 <br /> DELANO,MN 55328- <br /> (952)913-2451 <br /> Minnesota State License#:BUIL-155848 <br /> OWNER <br /> KOEHLER,TIMOTHY&DANIELLE <br /> 4205 NORTH SHORE DR <br /> MOiJND,MN 55364- <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. 'I'his permit is for only the work described and dces <br /> not grant permission for additional or related work which requires separate <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 aze <br /> requested in conformance with the State Building Code.1'his permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />