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4 CITY OF ORONO * 2012 - 00415 *
2750 KELLEY PARKWAY DATE ISSUED: 05/17/2012
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 685 OLD CRYSTAL BAY RD N
PIN : 33-118-23-21-0002
LEGAL DESC : UNPLATTED 33 118 23
LOT 000 BLOCK 000
PERMIT TYPE ADVANCED PLAN REVIEW
PROPERTY TYPE INSTITUTIONAL-SCHOOL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 5,000.00
NOTE: ADVANCED PLAN REVIEW FEE
BUILDING PERMIT FOR OPEN PAVILLION-PERMIT#2012-00416
VALUATION-$5,000
OVERPAYMENT OF$3.30 WAS PAID WITH CHECK#7713-NEEDS TO BE APPLIED TO THE BUILDING PERMIT FEE.
APPLICANT ADVANCED PLAN REVIEW 76.70
SCHOOLS,ORONO PUBLIC TOTAL 76.70
765 OLD CRYSTAL BAY RD N
LONG LAKE,MN 55356-
OWNER
SCHOOLS,ORONO PUBLIC
765 OLD CRYSTAL BAY RD N
LONG LAKE,MN 55356-
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 does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type 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 180 days at any time after work has commenced
The applicant is responsible for assuring all required inspections are
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 Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
2750 Kelley Parkitay
Orono NN 55356
Receipt No: 3.006876 May 17, 2012
County of iii ISD #278
Previous Balance: •00
Permits
2012-00415 685 Old 76.70
pial Bay Rd
101-34410
Plan heck/Site Exam Fees
Perait5
2012-t�415 Applied to 3.3
building fee
101-34440
Bldg Permits-mail in fees
Total: 80.00
Check No: 7713 80.00
Coimty of HN ISD #278 80.00Total Applied:
Lange Tendered: .00
05/17/2012 02:01PM