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CITY OF ORONO * 2 0 1 4 - PJ 1 2 7 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/3U2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1165 FERNDALE RU W <br /> PIN : 02-117-23-43-0026 <br /> LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPF. : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> ACTIVITY . <br /> .� <br /> VALUATION : $ 175,000.00 <br /> NOTr: PLEASE FILL IN THE FOLL.OWING: <br /> VALUATION OF PLRMIT:$ 17�,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: RF.MODI?], <br /> PLRMI"I'#THIS PRE-PAYMEN'T IS 7'IED TO:: 2014-01275 <br /> ANPLICANT ADVANCED PLAN REVIEW 979.39 <br /> STREETER&ASSOCIATES TOTAL 979.39 <br /> Payment(s) <br /> 18312 MINNETONKA BLVD CREDIT CARD 2061 979.39 <br /> WAYZATA, MN 55391 <br /> (612)449-9448 <br /> Minnesota State License#: BUIL-1380 <br /> OWNER <br /> BROOK, ROBERT <br /> 1 165 FERNDALE RD W <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 specitications,applicablc City approvals,and thc <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 180 day�s oY the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> I�he applicant is responsible for assuring all required inspections are <br /> requested in conlormance with the State Building Code."This pennit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />