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�`' CITY OF ORONO * z 0 1 4 - 0 1 0 6 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/22/2014 <br /> t ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1810 SHADYWOOD RD <br /> P[N : 17-117-23-21-0027 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 022 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 175,000.00 <br /> NOTE: PLGASE FILL IN TH[?FOLLOWING: <br /> VALUA"I ION OF PERMI"I':$ 175,000.00 <br /> 1'YPE?OF PFRMIT Tf IIS PAYMENT IS F02 AllDI'I�ION <br /> Pf?RMIT#'i'HIS PRE:PAYMENT IS TIED T0:2014-01068 <br /> APPLICANT ADVANCED PLAN REVIEW 979.39 <br /> LITE CONSTRUCTION TOTAL 979.39 <br /> (320)275-3677 Payment(s) <br /> CHECK 004887 979.39 <br /> Minnesota State License#: BUIL-1450 <br /> OWNER <br /> RICHARDSON, JENNY <br /> 1810 SHADYWOOD RD <br /> WAYZATA, MN 55391- <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 /> no[grant pemiission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing[his type of work <br /> shall be compied with�i�hether or no[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 /> � <br /> i� ' ';- l �� `�il.l C' �y�� iy � ���� r <br /> , � ��/��,� , <br /> Applicant Permitee Signature Date Issued By Signature Date <br />