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CITY OF ORONO � <br /> 2750 KELLEY PARKWAY * Z 0 1 2 — 0 fd 3 2 2 * <br /> DATE ISSUED: 04/26/2012 <br /> ' ORONO,MN 55356- <br /> �" 952 249-4600 FAX: 952 249-4616 <br /> ADDRE�S : 2178 SHADYWOOD RD <br /> PIN : 17-117-23-42-0009 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 017 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DOORS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 7,911.00 <br /> NOTE: 3 ENTRY AND 3 STORM DOOR REPLACEMENTS <br /> APPLICANT pERMIT FEE SCHEDULE 162.25 <br /> PELLA NORTHLAND STATE SURCHARGE(VALUATION) 3.96 <br /> 15300 25TH AVE N.-SUITE# 100 <br /> PLYMOUTH,MN 55447 MAIL-IN FEE 2.00 <br /> (952)345-6047 TOTAL 168.21 <br /> Minnesota State License#:BC645090 <br /> OWNER <br /> ANDERSON,MR.&MRS.CURTIS <br /> 2178 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 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 I80 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 cayse. <br /> `'�'k.�. (ir- / / / / <br /> Applicant Permitee Signature Date Issued By Sig ture ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />