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, CITY OF ORONO * z 0 1 6 — 0 fd 9 9 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 865 FERNDALE RD W <br /> PIIY : 02-117-23-44-0006 <br /> LEGAL DESC : AUDITOR'S SUBD.NO. l84 <br /> : LOT 104 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 45,000.00 <br /> NOTE: PLEASE F[LL IN THE FOLLOWING: <br /> VALUATION OF PERM[T:$45,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ATTACHED GARAGE <br /> PERMIT#THIS PRE-PAYMENT IS TIED T02016-00992 <br /> APPLICANT ADVANCED PLAN REVIEW 428.66 <br /> REV[S[ON LLC TOTAL 428.66 <br /> Payment(s) <br /> 153 E LAKE STREET CHECK 12419 428.66 <br /> WAYZATA, MN 55391- <br /> (952)540-7150 <br /> Minnesota State License#: BUIL-BC639027 <br /> OWNER <br /> ERICKSON&SHARON NESBITT, STEVEN <br /> 865 FERNDALE RD W <br /> ORONO, 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 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 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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 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 /> � _ � �rf�� � U c�._� � � '_..� f �0 � i �i �Cr <br /> Applicant ermitee Signatur Date Issued By Signature Date <br />