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CITY OF ORONO �I � 1 1 � �I�'I it I 11111 <br /> * <br /> 2750 KELLEY PARKWAY * 20 1 6 - 0 1 1 9 <br /> DATE ISSUED: 09/23/22 016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 585 ORCHARD PARK RD <br /> PIN : 31-118-23-14-0001 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 400,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 400,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOUSE <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01180 <br /> APPLICANT ADVANCED PLAN REVIEW 1,949.95 <br /> TOTAL 1,949.95 <br /> TJB HOMES INC Payment(s) <br /> 9100 BALTIMORE STREET NE CHECK 056295 1,949.95 <br /> SUITE 1-2 <br /> BLAINE,MN 55449- <br /> OWNER <br /> THOMAS,DONALL&HENRIETA <br /> 585 ORCHARD PARK 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 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 /> Applicant Permitee Signature Date Issued By Signature Date <br />