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CITY OF ORONO PERMIT NO.: 2010-01040 <br /> 2750 KELLEY PARKWAY <br /> r <br /> ORONO, MN 55356- DATE ISSUED: 10/2U2010 <br /> " (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3800 DICKSON EXTENSION <br /> PIN : 17-117-23-31-0020 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 001 BLOCK O10 <br /> PERMIT TYPE : ADVANCED PLAN REV[EW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 1,800.00 <br /> NO"CF: PLI;ASE FILL IN"I'l IF,FOLLOWING: <br /> VALUA"r[ON OF PERMI"r: $ 1800.00 <br /> I'YYF,OF PF,RMI��THIS YAYMEN"I'IS FOR: nN ACCGSSORY BUILD[NG <br /> TI IIS PRG-PAYMENT IS TIED TO: 2010-01013 <br /> APPLICANT <br /> ADVANCED PLAN REVIEW 43J1 <br /> ADAM BLAIR, KELLY HARRISON/ TOTAL 43.71 <br /> 3800 DICKSON EXTENSION <br /> SPRING PARK, MN 55384- <br /> OWNER <br /> ADAM BLAIR, KELLY HARR[SON/ <br /> 3800 DICKSON EXTENSION <br /> SPRING PARK, MN 55384- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perYormed according to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Building Code. "�his pennit is for only the work described and docs <br /> not grant permission for additional or related work which requires separate <br /> permits. nll provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.'I�his permit will <br /> expire and become null and void if construction authorized is not <br /> commenccd within 180 days of thc date of issuance,or if construction is <br /> suspended for a period of I 80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with U�e State[3uilding Code.This permit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued{3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />