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CITY OF ORONO III 1111111 II II 1101111 II <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/18/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1900 WEST FARM RD <br /> PIN : 27-118-23-43-0019 <br /> LEGAL DESC : THE FARM AT LONG LAKE <br /> : LOT 020 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : 0/S BUILDING-UNDEFINED <br /> VALUATION : $ 26,000.00 <br /> NOTE: REPLACE(25)WINDOWS AND RESIDE(3)SIDES OF HOUSE. <br /> APPLICANT PERMIT FEE SCHEDULE 423.75 <br /> STATE SURCHARGE(VALUATION) 13.00 <br /> SELA ROOFING&REMODELING, INC. TOTAL 436.75 <br /> 4100 EXCESIOR BLVD <br /> Payment(s) <br /> ST. LOUIS PARK,MN 55416- <br /> (952)915-7227 CHECK 35053 436.75 <br /> Minnesota State License#: BUIL-BC1050 <br /> OWNER <br /> WILLITS, MR.&MRS. <br /> 1900 WEST FARM 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 /> revok-d at any t' e f• ..e cause. <br /> 041111.0 <br /> CV u 9 / 8� /y <br /> rant Permitee Signature Date <br /> Issu By Signature Date <br />