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CITY OF ORONO * 2 0 1 7 - 0 0 2 4 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/15/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 140 BROWN RD S <br /> PIN : 03-117-23-12-0011 <br /> LEGAL DESC : KALLESTAD ACRES <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 15,577.00 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 15,577.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: FOUNDATION REPAIR <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00245 <br /> APPLICANT ADVANCED PLAN REVIEW 191.27 <br /> TOTAL 191.27 <br /> Stanek Property Investments of Minn Payment(s) <br /> STANEK,KEVIN CHECK 8189 191.27 <br /> 20165 COTTAGEWOOD AVE <br /> EXCELSIOR,MN 55331- <br /> OW IYER <br /> Stanek Property Investments of Minn <br /> STANEK, KEVIN <br /> 20165 COTTAGEWOOD AVE <br /> EXCELSIOR,MN 55331- <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 dces <br /> not grant permission for additional or related work which requires separate <br /> pertnits. AII 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 l80 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 /> 3 �1�� /� <br /> Applicant Permitee Signature Date Issued By Sigr►ature Date <br />