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CITY OF ORONO PERMIT NO.: 2011-00557 <br /> �"' 2750 KELLEY PARKWAY <br /> l ORONO, MN 55356- �ATE ISSUEn: 06/30/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3050 SIXTH AVE N <br /> PIN : 28-118-23-32-0015 <br /> LEGAL DESC : LESLIE ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 13,075.00 <br /> APPLICANT PERMIT FEE SCHEDULE 250.75 <br /> DCC [NC STATE SURCHARGE(VALUATION) 6.54 <br /> 1620 215TH LANE NW <br /> OAK GROVE,MN 55011- TOTAL 257.29 <br /> (612)282-9010 <br /> Minnesota State License#: 20638528 <br /> OWNER <br /> WELCH& MELODIE MARTIN,TIMOTHY <br /> 3050 SIXTH AVE N <br /> LONG LAKE,MN 55356 <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 consVuction is <br /> suspended f'or a period of 180 days at any time after work has commenced. <br /> The applicant is responsible Yor assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for ue cause. <br /> �.. y,� lv 1.3C� l�d l rt-�--C_�� L.'�-yY1Ccv'7�� � �' � ?'�' �� <br /> App icant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />