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CITY OF ORONO PERMIT NO.: 2011-01322 <br /> � � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DA'rE�SSUEn: 10/25/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1990 SHADYWOOD RD <br /> PIN : 17-117-23-24-0027 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 040 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 3,946.00 <br /> APPLICANT pERMIT FEE SCHEDULE 103.25 <br /> PRO BUILT AMERICA STATE SURCHARGE(VALUATION) 1.97 <br /> 2211 11TH AVE.E. <br /> MN 55109- MISC FEE 0.00 <br /> (651)770-5570 MAIL-IN FEE 2.00 <br /> Minnesota State License#: BC 2035684 TOTAL 107.22 <br /> OWNER <br /> MACK,ROBERT&ARDELL <br /> 1990 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 Bui�ding Code. This permit is for only the work described and dces <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming 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$tate Building Code.This permit may be <br /> revoked at any time for due cause. <br /> `,Y�`'� �'K, / / / / <br /> Applicant Permitee Signature Date Issued By S' ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />