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CITY OF ORONO * 2 0 1 5 - 0 1 0 4 0 * <br /> _ 2750 KELLEY PARKWAY DATE ISSUED: 08/17/2015 <br /> � � ORONO, MN 55356- <br /> (952 249-4600 FAX: (952 249-4616 <br /> AD�DRES� : 3115 SUSSEX RD <br /> PIN : 04-117-23-32-0015 <br /> LEGAL DESC : FOX BEND <br /> : LOT 004 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION T PE : WINDOWS <br /> ACTNITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 5,020.00 <br /> NOTE: REPLACE 4 W[ DOWS IN EXISTING OPENINGS <br /> � <br /> � <br /> I <br /> i <br /> d <br /> PPLICANT PERMIT FEE SCHEDULE 139.40 <br /> STATE SURCHARGE(VALUATION) 2.51 <br /> MINNESOTA EXTER ORS INC. TOTAL 141.91 <br /> 8600 JEFFERSON HI HWAiY Payment(s) <br /> OSSEO,MN 55369 CHECK 202414 141.91 <br /> (763)391-5508 <br /> Minnesota State Licens #: BUIL-BC002877 <br /> OWNER <br /> MARY RASKOB,DA IEL pELMORE& <br /> 3115 SUSSEX RD <br /> LONG LAKE,MN 553 6- <br /> AGREEMENT ND SWORN STATEMENT <br /> The work for which this pe it is issued shall be performed according to <br /> the approved plans and spec �cations,applicable City approvals,and the <br /> State Building Code. This p rmit is for only the work described and does <br /> not grant permission for add tional qr related work which requires separate <br /> permi[s. All provisions of la s and prdinances goveming this type of work <br /> shall be compied with whet r or n specified herein.This permit will <br /> expire and become null and oid if struction authorized is not <br /> commenced within 180 days of the ate of issuance,or if construction is <br /> suspended for a period of 18 days any time after work has commenced. <br /> The applicant is responsible or ass ing all required inspections are <br /> requested in conformance w h the ate Building Code.This permit may be ' � <br /> revoked at any time for due ause. <br /> ` .� 0 / '--�-�'�� � / / � <br /> Applicant Permitee Sign ur Date Issued By Signature Date <br /> I� <br />