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CITY OF ORONO * Z 0 1 4 - 0 1 1 0 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/0]/2014 <br /> � ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1856 SHADYWOOD RD <br /> PIN : 17-117-23-24-0017 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 2,129.00 <br /> NOTE: REPLACE(1)WINDOW INTO EXISITNG OPENING <br /> APPLICANT PERMIT FEE SCHEDULE 88.50 <br /> STATE SURCHARGE(VALUATION) 1.06 <br /> THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00 <br /> 2690 CUMBERLAND PKWY,STE 300 TOTAL 91.56 <br /> 30339- <br /> (763)542-8826 Payment(s) <br /> Minnesota State License#:BUIL-20268257 CHECK 69296 91.56 <br /> OWNER <br /> SEIFERT,MILTON <br /> 1856 SHADYWOOD RD <br /> WAYZATA,MN 55391- <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 /> 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 pertnit may be <br /> revoked at any time for due cause. <br /> /� v�✓1 �J�•—� V A/�Gl�N �/ i /` 1 <br /> Applicant Permitee Signature Date Issued y Signature Date <br />