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t � <br /> CITY OF ORONO * 2 0 1 5 - PJ 1 4 2 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: l U05/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4645 ST.ANDREWS ST <br /> PIN : T000121 <br /> LEGAL DESC : LAKEVIEW OF ORONO <br /> : LOT 14 BLOCK 3 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 950,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$950,000 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW I-IOUSE <br /> PERMIT#THIS PR�PAYMENT IS TIED TO:2015-01430 <br /> APPLICANT ADVANCED PLAN REVIEW 3,894.86 <br /> TOTAL 3,894.86 <br /> SWANSON HOMES Payment(s) <br /> 1360 HAMEL ROAD CHECK 35924 3,894.86 <br /> MEDINA,MN 55340- <br /> (763)478-0320 <br /> Minnesota State License#: BUIL-627982 <br /> OWNER <br /> Source Land Development Inc. <br /> 18215 45TH AVE N <br /> STE D <br /> PLYMOUTH,MN 55446- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit is issued shall be performed according to <br /> the approved ptans 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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 consuuction 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 />