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CITY OF ORONO * Z 0 1 6 - 0 0 6 7 6 * <br /> ..`' 2750 KELLEY PARKWAY DATE ISSUED: 06/14/2016 <br /> � ORONO,MN 55356- <br /> 952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 115 SMITH AVE <br /> PIN : 02-117-23-21-0016 <br /> LEGAL DESC : ORONO ORCHARDS <br /> : LOT 063 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTIVITY . <br /> VALUATION : $ 4,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 4,000.00 <br /> TYPE OF PERMIT THIS PAYI�NT IS FOR: BATH REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00677 <br /> APPLICANT ADVANCED PLAN REVIEW 70.45 <br /> RAM HOMES INC TOTAL 70.45 <br /> 5524 DICKSON RD Payment(s) <br /> MINNETONKA,MN 55391- CREDIT CARD 3180 70.45 <br /> OWNER <br /> MILLER,THOMAS <br /> 115 SMITH AVE <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he work for which this pertnit is issued shall be perfortned 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 dces <br /> not grant permission for additional or related work which requires separate <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 />