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CITY OF ORONO PERMIT NO.: 2011-00568 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 07/05/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3245 WATERTOWN RD <br /> PIN : 05-117-23-11-0001 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT 002 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 5,480.91 <br /> NOTE: TEAR OFF REROOF <br /> APPLICANT PERMIT FEE SCHEDULE 132.75 <br /> SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 2.74 <br /> 12366 RIVER RIDGE ROAD <br /> BURNSVILLE,MN 55337- MAIL-IN FEE 2.00 <br /> (612)861-7000 TOTAL 137.49 <br /> Minnesota State License#:20593656 PAID WITH CC# 1521 <br /> OWNER <br /> RHAME,CARL <br /> 3245 WATERTOWN 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 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 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 /> revoke at any time for du cause. <br /> 71 ,5111 <br /> Applicant Permitee Signature Date IssueAy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />