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CITY OF ORONO * 2 0 1 4 - 0 0 5 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/03/2014 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952)249-4616 <br /> ADDRESS : 1645 SHADYWOOD RD <br /> PIN : 17-117-23-22-0013 <br /> LEGAL DESC : LJNPLATTED 17 1 l7 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTIVITY . - <br /> VALUATION : $ 325,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 325,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADV PLAN REVIEW FOR NEW STRUCTURE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2014-00553 <br /> APPLICANT ADVANCED PLAN REVIEW 1,564.39 <br /> TOTAL 1,564.39 <br /> ATLAS HOMES INC Payment(s) <br /> 14450 117TH AVE N CHECK 009142 1,564.39 <br /> DAYTON,MN 55369- <br /> (763)691-9044 <br /> Minnesota State License#: BUIL-BC20269686 <br /> OWNER <br /> LANDSOURCE <br /> 550 25TH AVE N <br /> ST CLOUD,MN 56301- <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. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances governing 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />