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CITY OF ORONO * 2 0 1 2 - 0 0 4 8 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/OU2012 <br /> » ORONO, MN 55356- <br /> 4 � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 455 SUSSEX LA <br /> PIN : 04-117-23-32-0011 <br /> LEGAL DESC : FOX BEND <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> VALUATION : $ 50,000.00 <br /> NOTE: REMOVE PARTIAL STUCCE,REPAIR SHEATHING&STICK FRAMING,DETACH AND RESET AFFECTED WINDOWS <br /> APPLICANT pERMIT FEE SCHEDULE 681.75 <br /> UNGERMAN CONSTRUCTION INC. STATE SURCHARGE(VALUATION) 25.00 <br /> 4450 NICOLLET AVE S TOTAL 706.75 <br /> MINNEAPOLIS,MN 55419- <br /> (612)825-2800 PAID WITH CC# 4264 <br /> Minnesota State License#:BC001239 <br /> OWNER <br /> CRAWFORD,BRUCE&CAROL <br /> 455 SUSSEX LA <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 dces <br /> not grant permission for additional or related work which requires separate <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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ��Z �`- � / � / �� /'Yl,�rt i i <br /> Applicant Permitee Signature Date Issued By ' ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />