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CITY OF ORONO * Z 0 1 5 - 0 0 7 6 9 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 06/15/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1629 BOHNS POINT RD <br /> PIN : 17-117-23-I1-0005 <br /> LEGAL DESC : REG. LAND SURVEY NO.0565 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REV[EW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REV[EW <br /> VALUATION : $ 10,000.00 <br /> NOTE: PLEASE F[LL IN THE FOLLOWING: <br /> VALUATION OF PERMIT: $ 10,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW W[NDOWS <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-00768 <br /> APPLICANT ADVANCED PLAN REVIEW 130.88 <br /> TOTAL 130.88 <br /> MATTSON SCHOSTER LLC Payment(s) <br /> 332 2ND STREET CHECK 7937 130.88 <br /> EXCELSIOR, MN 55331- <br /> (612)751-0488 <br /> Minnesota State License#: BUIL-BC663107 <br /> OWNER <br /> AMPLATZ,CAROL[NE <br /> 345 LEAF ST <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 onty 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 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 i co ormance with the State Building Code.This permit may be <br /> revoked a �ime or e se. <br /> — i <br /> `��.s� �� �� �� � l� <br /> p icant Pe ee ignature Date [ssued y Signat Date <br /> I� � <br />