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CITY OF ORONO * 2 0 1 4 - 0 0 0 1 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU07/2014 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 2610 MAPLERIDGE LA <br /> PIN : 21-117-23-21-0009 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1468 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : ADVANCED PLAN REVIEW <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADVANCED PLAN REVIEW <br /> VALUATION : $ 24,740.00 <br /> NOTE: PLEASE FILL(N THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 24,740.00 <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: INTERIOR REMODEL <br /> THIS PRE-PAYMENT IS TIED T0:201400018 <br /> APPLICANT ADVANCED PLAN REVIEW 268.45 <br /> DOUG DZURIK CONSTRUCTION TOTAL 268.45 <br /> Payment(s) <br /> 1700 NIAGARA LN N CREDIT CARD 7104 268.45 <br /> PLYMOUTH,MN 55447 <br /> (612)221-2431 <br /> Minnesota State License#: BUIL-BC062372 <br /> OWNER <br /> FESLER&JANE ZELETES, DANIEL <br /> 2610 MAPLERIDGE LA <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 sepazate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shal(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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />