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CITY OF ORONO PERMIT NO.: 2011-00174 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356— DATE ISSUED: 03/22/2011 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4700 WEST BRANCH RD <br /> PIN : 06-117-23-33-0004 <br /> LEGAL DESC : UNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SIDING l5 1)2I tic) <br /> VALUATION : $ 3,985.00 <br /> NOTE: PINE SIDING <br /> • <br /> • <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 103.25 <br /> PETERSON,RONALD STATE SURCHARGE(VALUATION) 5.00 <br /> 4700 WEST BRANCH RD TOTAL 108.25 <br /> MOUND, MN 55364 <br /> OWNER <br /> PETERSON, RONALD <br /> 4700 WEST BRANCH RD <br /> MOUND,MN 55364 <br /> • <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 /> re d at a liihebr due cause. 044a/L_ <br /> 3 <br /> litiviztvivor <br /> Applicant Permitee Signature Date Is i'. By Signature Date If <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />