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CITY OF ORONO * 2012 - 01043 * <br /> .. 2750 KELLEY PARKWAY DATE ISSUED: 10/17/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS 2643 THOROUGHBRED LA <br /> PIN 04-117-23-12-0021 <br /> LEGAL DESC OLD CRYSTAL BAY ROAD 2ND ADDN <br /> LOT 006 BLOCK 002 <br /> ORMIT TYPE ADVANCED PLAN REVIEW <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ADVANCED PLAN REVIEW <br /> VALUATION $ 34,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 34,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: DETACHED GARAGE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-01042 <br /> APPLICANT ADVANCED PLAN REVIEW 331.34 <br /> SHORELINE BUILDERS TOTAL 331.34 <br /> 2184 ISHADYWOOD RD <br /> WAYZATA,MN 55391- PAID WITH CC# 4377 <br /> (763);506-0629 <br /> Minnesota State License#:20630814 <br /> OWNER <br /> CHAMPLIN,3UDSON&ALEYA <br /> 2643 THROUGHBRED LA <br /> LONG LAKE,MN 55356- <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 separate <br /> permits, All provisions of laws and ordinances governing this type of work <br /> shall bel 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 /> suspendled for a period of 180 days at any time after work has commenced. <br /> The akae <br /> risible for assuring all required inspections are <br /> requence with the State Building Code.This permit may be <br /> revokr due cause. <br /> Ap c Pennitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />