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CITY OF ORONO * z B 1 4 - � 1 a 7 2 * <br /> �� 2750 KELLEY PARKWAY DATE ISSUED: 09/22/2014 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2565 NORTH SHORE DR <br /> PIN : 09-117-23-41-0004 <br /> LEGAL DESC . UNPLATTED 09 1 17 23 City ot Orono <br /> 2750 Kel ley �'ai icway <br /> : LOT 000 BLOCK 000 Oruno MN �'�356 952-249-46U0 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE . RESIDENTIAL Receipt No: 3.011'0'36 Sep 22. 2U14 <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 1,000.00 ANURADE, JEFFkEi' & MELISSA <br /> NOTE: PLEASE FILL IN THL�: FOLLOWING: <br /> Previous Balance: .00 <br /> VALUATION OF PGRMIT:$ _1000.00 Permit� <br /> p2014-01072 26.81 <br /> T'YPE OE�PERMI"I'"I�fiIS YAYMFN'I'IS FOR: SHGD 101-34410 <br /> Plan Check/Site Exam Fees <br /> PERMI"I'#"I'HIS PRF,-NAYMENT IS"f[F,D TO: 2014-01073 <br /> Total: 26.81 <br /> Check <br /> Check No: 6087 26.81 <br /> Payor: <br /> �������F .IEFFREY & MELISSA <br /> 26.81 <br /> APPLICANT ADVANCED PLAN REVIEW 26.81 <br /> ANDRADE,JEFFREY L& MELISSA L TOTAL 26.81 <br /> Payment(s) <br /> 2565 NORTH SHORE DR CHECK 6087 26.81 <br /> WAYZATA, MN 5�391- <br /> OWNER <br /> ANDRADE, JEFFREY L& MEi.ISSA L <br /> 2565 NORTH SHORE DR <br /> WAYZATA, MN 55391- <br /> AGREEMEIYT AND SWORN STATEMENT <br /> The work Yix��hich this permit is issued shall be perfonned according to <br /> the approved plans and specitications,applicable City approvals,�nd the <br /> S[a[e Building Code. This permit is for only the work described and does <br /> not grant pennission for additional or related work�chich requires sepnrate <br /> permi[s. All provisions of laws and ordinances governing[his type oY work <br /> shall be compied��•ith whether or not specified herein.This permit�vill <br /> expire and become null and void if construction audiorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 dlys at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in confomiance with the State Building Code.This pennit may be <br /> revoked at anv time for due cause. <br /> / / <br /> Applicant Permitce Signature Date Issucd Ry Signaturc Date <br />