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�- <br /> t CITY OF ORONO * 2 0 1 6 - 0 0 1 � 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/03/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2699 KELLY AVE <br /> Pllv : 21-117-23-23-0041 <br /> LEGAL DESC : WALTERS PORT <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 120,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUAT[ON OF PERMIT:$ 120,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL <br /> PERM[T#THIS PRE-PAYMENT IS TIED TO:2016-00114 <br /> APPLICANT ADVANCED PLAN REVIEW 803.35 <br /> MORIN&TANYA SREPEL,CHARLES TOTAL 803.35 <br /> Payment(s) <br /> 2699 KELLY AVE CHECK 1034 803.35 <br /> EXCELSIOR,MN 55331- <br /> OWNER <br /> MORIN&TANYA SREPEL,CHARLES <br /> 2699 KELLY AVE <br /> EXCELSIOR, MN 55331- <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 goveming 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[ime 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 ue cause. <br /> (� /' � � <br /> `� - /(� /��-'�-''� G'� �-��_ �'�C� � � � � � <br /> 'cant ermitee i ature Date Issued By Signature Date <br />