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� •� <br /> CITY OF ORONO * 2 0 1 2 - 0 0 7 5 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/06/2012 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2990 SUSSEX RD <br /> PIN : 04-117-23-31-0020 <br /> LEGAL DESC : FOX BEND <br /> : LOT 3 BLOCK 4 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 7,731.00 <br /> NOTE: REPLACE(4)WINDOWS INTO EXISTING OPENINGS. <br /> APPLICANT pERMIT FEE SCHEDULE 162.25 <br /> RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 3.87 <br /> 1920 COUNTY RD C. WEST <br /> ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 <br /> (612)502-4777 TOTAL 168.12 <br /> Minnesota State License#: BC130983 PAID WITH CC# 8788 <br /> OWNER <br /> KELLY,JUSTIN&SUSAN <br /> 2990 SUSSEX RD <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 sepazate <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 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 State Building Code.This permit may be <br /> revoked at any time for d ause. <br /> • �� � � / � / �O''� <br /> App icant ermitee ature Date Is By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />