HomeMy WebLinkAbout2011-00998 - adv plan review t -
CITY OF ORONO PERMIT NO.: 2011-00998
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/06/2011
(952)249-4600 FAX: (952)249-4616
REPRINTED ON 9/6/2011
ADDRESS : 840 OLD CRYSTAL BAY RD S
PIN : 09-117-23-12-0002
City
o
LEGAL DESC : UNPLATTED 09 117 23 2750 Kelley of r�Parkway
LOT 000 BLOCK 000 Orono MN55356 952-243-4600
PERMIT TYPE : ADVANCED PLAN REVIEW Receipt No: 3.005396 Sep 6, 2011
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW Charles Cudd LLC
VALUATION : $ 1,128,000.00 Previous Balance: .00
NOTE: PLEASE FILL IN THE FOLLOWING: Per00
20111Perm-00998 840 Old 4,204.69
l
VALUATION OF PERMIT:$ 4204.69 101-34410
0Ap Rd S
Plan Check/Site Exam Fees
TYPE OF PERMIT THIS PAYMENT IS FOR: SINGLE FAMILY HOUSE
Total: 4,204.69
PERMIT#THIS PRE-PAYMENT IS TIED TO:2011-01003 New Balance: 4,204.69-
Check
Check No: 6014 4,204.69
Payor:
Charles Cudd LLC
Total Applied: 4,204.69
Change Tendered: .00
09/06/2011 11:35AM
APPLICANT ADVANCED PLAN REVIEW 4,204.69
CHARLES CUDD LLC TOTAL 4,204.69
15050 23RD AVENUE N
PLYMOUTH,MN 55447-
Minnesota State License#:20635245
OWNER
WILLIAMS,JAMES&HEIDI
840 OLD CRYSTAL BAY RD S
WAYZATA,MN 55391-
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. �}
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Applicant Permitee Signature Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.