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CITY OF ORONO III 1 ill 111 11.111 11 Ill 1111 <br /> 2750 KELLEY PARKWAY * 2016 - 01 .124 * <br /> DATE ISSUED: 09/15/2016 <br /> i ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1380 ORONO LA <br /> PIN : 02-117-23-34-0012 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1350 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 25,000.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 25,000.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: IN-GROUND POOL <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01123 <br /> APPLICANT ADVANCED PLAN REVIEW 281.89 <br /> TOTAL 281.89 <br /> PRESTIGE POOLS <br /> 87 COUNTY ROAD C WEST Payment(s) <br /> CHECK 17862 281.89 <br /> ST.PAUL,MN 55117- <br /> OWNER <br /> Luke Beltnick Revocable Trust <br /> BELTNICK,LUKE&ELENA <br /> 3018 EMERSON AVE S <br /> MINNEAPOLIS,MN 55408- <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 /(17) <br /> revoked at any time for due cause. .,.( �" <br /> /) r <br /> 11214// 5—/.5--/.4, 0 ( ,....12 A .._,PLS-i" (, i /Si & <br /> Applicant Permitee Sire Date Issued By Signatur! Date <br />