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CITY OF ORONO * 2 0 1 3 - 0 0 3 4 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/13/2013 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1795 SHADYWOOD RD <br /> PIN : 17-117-23-21-0008 <br /> LEGAL DESC : REG.LAND SURVEY NO.0702 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 12,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 12,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT-DECK <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2013-00341 <br /> APPLICANT ADVANCED PLAN REVIEW 143.81 <br /> BETZ BUILDERS INC. TOTAL 143.81 <br /> 300 CRESTVIEW AVE. <br /> LONG LAKE,MN 55356 <br /> (612)221-2963 <br /> Minnesota State License#: BC3515 <br /> OWNER <br /> DIERCKS,MICHAELA <br /> 1795 SHADYWOOD RD <br /> P.O.BOX 81(NAVARRE <br /> WAYZATA,MN <br /> AGREEME1vT 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 separate <br /> permits. All provisions of laws and ordinances goveming this rype 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' co ormance with the State Building Code.This permit may be <br /> revoked t any ime for due cause. <br /> / � /� / / / <br /> Applicant Permitee Signature Date Issued By S' ature Date <br /> SEPA TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB <br />