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CITY OF ORONO *�6 _ 0 1 4 2 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1 U10/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> RESS : 1415 PARK DR <br /> : T000162 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 117,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OP PERMIT:$ 117,000.00 <br /> "CYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01423 <br /> APPLICANT ADVANCED PLAN REVIEW 791.06 <br /> R HOUSE DESIGN BUILD TOTAL 791.06 <br /> Payment(s) <br /> P.O. BOX 1153 CHECK 1647 791.06 <br /> CHANHASSEN,MN 55317- <br /> (952)393-4667 <br /> Minnesota State License#:BUIL-BC678783 <br /> OWNER <br /> QRANTER, BRIAN <br /> 1415 PARK DRNE <br /> MOUND, MN 55364- <br /> AGRGEMENT 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. This permit is for only the work described and docs <br /> not grant permission for additional or related��ork which requires separate <br /> permits. All provisions of la�vs and ordinances governing this type of work <br /> shall be compicd 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�period of 180 days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked a any time for due cause. �� ��� <br /> I �.�.� � <br /> i �, �����,`-e- z � �S� l/, / � <br /> � � /� <br /> App ' an " er itee S�gna e Date Issued By Signature Date <br />