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CITY OF ORONO * 2 0 1 2 - 0 0 4 1 4 * <br /> .� " � , 2750 KELLEY PARKWAY DATE ISSUED: 05/16/2012 <br /> ' , ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1205 SHORELINE DR <br /> PIN : 02-117-23-43-0015 <br /> LEGAL DESC : REG.LAND SURVEY NO.0397 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DOORS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 5,435.00 <br /> NOTE: REPLACE(1)DOOR WITHIN EXISTING OPENING. <br /> APPLICANT pERMIT FEE SCHEDULE 132.75 <br /> RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 2.72 <br /> 1920 COUNTY RD C.WEST <br /> ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 <br /> (612)502-4777 TOTAL 137.47 <br /> Minnesota State License#:BC130983 PAID WITH CC# 8788 <br /> OWNER <br /> JACKLEY ET AL,JAY M <br /> 1205 SHORELINE DR <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 percnission for additional or related work which requires sepazate <br /> pertnits. 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any tir�e for due cau . <br /> �/ / / l �/ Cl?/ �� <br /> Applicant Permitee ' nat e Date Is u By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />