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• • r� CITY OF ORONO <br /> � � 2750 KELLEY PARKWAY * z 0 1 2 — 0 0 6 3 5 * <br /> DATE ISSUED: 07/03/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1595 MAPLE PL <br /> PIN : 08-117-23-33-0035 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 013 BLOCK 006 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCT[ON TYPE : ADVANCED PLAN REVIEW <br /> City of Orono <br /> VALUATION : $ 181,900.00 2750 ;;elley ParkMay <br /> NOTE: PLEASE FILL IN THE FOLLOWING: Q'"v� � �� �-24�� <br /> VALUATION OF PERMIT:$ $181,900 Receipt No: 3.t}471b9 1u1 3, 2Q12 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT Maole Glare LLC <br /> PERM[T#THIS PRE-PAYMENT IS TIED TO:2012-00636 Previous Balance: .4t1 <br /> Per�its <br /> �Q12-40635 1595 Maple 1,OOE.69 <br /> F�la�e <br /> 141-34410 <br /> Plan ChecklSite Exam Fees <br /> Total: 1,006.69 <br /> Check ----_____� <br /> Check Na: 30� 1,Opb.69 <br /> Payor: <br /> Maple Place lLC <br /> T�tal Applied: 1,006.69 <br /> Chanqe Ter�ered: ~ ~.00 <br /> APPLICANT ADVANCED PLAN REVIEW 1,006.69 <br /> DEAN JOHNSON HOMES, INC. TOTAL 1,006.69 <br /> 4700 CTY ROAD 19 <br /> MEDINA, MN 55357- <br /> (763)479-4820 <br /> Minnesota State License#: 20639439 <br /> OWNER <br /> Maple Place LLC <br /> 550 25TH AVE N <br /> ST. CLOUD, MN 56303- <br /> AGREEMENT A1vD SWORN STATEMENT <br /> The work for which this perrnit 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 wark <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is no[ <br /> commenced within 180 days of the 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 the State Building Code.This permi[may be <br /> revoked at any time for due cause. <br /> �'C"�� � �� -..�___ 7 / �s' /�z'� � Z. �i�%'�� / / <br /> Applicant Permitee Signature Uate Issue y S' nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABOV . <br />