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CITY OF ORONO * z 0 1 6 - 0 0 9 2 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/OS/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1669 NORTH FARM RD <br /> PIN : 27-118-23-44-0008 <br /> LEGAL DESC : THE FARM AT LONG LAKE <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 115,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 115,000.00 <br /> TYPE OF PERM[T THIS PAYMENT IS FOR: ADDITION REMODEL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00908 <br /> APPLICANT ADVANCED PLAN REVIEW 782.87 <br /> TOTAL 782.87 <br /> STREETER&ASSOCIATES Payment(s) <br /> 18312 MINNETONKA BLVD CHECK 103956 782.87 <br /> WAYZATA, MN 55391 <br /> (952)346-2499 <br /> Minnesota State License#: BUIL-BC-001380 <br /> OWNER <br /> BEENDERS&PETER MONTGOMERIE,ANTOINETTE <br /> 1669 NORTH FARM RD <br /> LONG LAKE,MN 55356- <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 rype of work <br /> shail 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 l80 days at any time afrer work has ommenced. <br /> The applicant is resp le for assyring all quired insp ions are <br /> requested in con�'ormanc with th tate ilding Cod . his permit may be nI/,J <br /> revoked�any time for ue ca� 7;' �K,'% <br /> / ,, / � �- �� 1�� _� 1-��- �/ � / b <br /> Applicant �te� ' nature Date [ssued By Signatu Date <br />