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t - <br /> CITY OF ORONO PERMIT NO.: 2011-00998 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/06/2011 <br /> (952)249-4600 FAX: (952)249-4616 <br /> REPRINTED ON 9/6/2011 <br /> ADDRESS : 840 OLD CRYSTAL BAY RD S <br /> PIN : 09-117-23-12-0002 <br /> City <br /> o <br /> LEGAL DESC : UNPLATTED 09 117 23 2750 Kelley of r�Parkway <br /> LOT 000 BLOCK 000 Orono MN55356 952-243-4600 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW Receipt No: 3.005396 Sep 6, 2011 <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW Charles Cudd LLC <br /> VALUATION : $ 1,128,000.00 Previous Balance: .00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: Per00 <br /> 20111Perm-00998 840 Old 4,204.69 <br /> l <br /> VALUATION OF PERMIT:$ 4204.69 101-34410 <br /> 0Ap Rd S <br /> Plan Check/Site Exam Fees <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: SINGLE FAMILY HOUSE <br /> Total: 4,204.69 <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2011-01003 New Balance: 4,204.69- <br /> Check <br /> Check No: 6014 4,204.69 <br /> Payor: <br /> Charles Cudd LLC <br /> Total Applied: 4,204.69 <br /> Change Tendered: .00 <br /> 09/06/2011 11:35AM <br /> APPLICANT ADVANCED PLAN REVIEW 4,204.69 <br /> CHARLES CUDD LLC TOTAL 4,204.69 <br /> 15050 23RD AVENUE N <br /> PLYMOUTH,MN 55447- <br /> Minnesota State License#:20635245 <br /> OWNER <br /> WILLIAMS,JAMES&HEIDI <br /> 840 OLD CRYSTAL BAY RD S <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 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 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 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 permit may be <br /> revoked at any time for due cause. �} <br /> / / 2 !/ (0 ./ // <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />