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CITY OF ORONO <br /> * 2 0 1 2 — 0 0 3 3 5 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/27/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 840 NORTH SHORE DR W <br /> PIN : 07-117-23-22-0005 <br /> LEGAL DESC UNPLATTED 07 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE ADVANCED PLAN REVIEW <br /> PROPERTY TYPE RESIDENTIAL City of Orono <br /> 750 <br /> CONSTRUCTION TYPE ADVANCED PLAN REVIEW Oron Kelley Parkway <br /> Orono MN 55356 952-249-4600 <br /> VALUATION $ 4,000.00 Receipt No: 3.006751 Apr 27, 2012 <br /> NOTE: PLEASE FILL IN THE FOLLOWING: <br /> VALUATION OF PERMIT:$ 4,000.00 Jim Hatchett <br /> TYPE OF PERMIT THIS PAYMENT IS FOR: ATTACHED DECK Previous Balance: .00 <br /> Permits <br /> 2012-CO335 940 North 67.11 <br /> PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00334 Shore Dr W <br /> 101-34410 <br /> Plan Check/Site Exam Fees <br /> Total: 67.11 <br /> Check <br /> Check No: 4797 67.11 <br /> Payor: <br /> Jin Hatchett <br /> Total Applied: 67.11 <br /> Change Tendered: .00 <br /> 04/27/2012 03:1584 <br /> APPLICANT ADVANCED PLAN REVIEW 67.11 <br /> HATCHETT,JIM&JUDY TOTAL 67.11 <br /> 840 NORTH SHORE DR W <br /> MOUND,MN 55364- <br /> OWNER <br /> HATCHETT,JIM&JUDY <br /> 840 NORTH SHORE DR W <br /> MOUND,MN 55364- <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 i nfor . ce w' a State Building Code.This permit may be �� <br /> rev cause. <br /> -- <br /> Ap f1dwriniteeSignature Da Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />