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• CITY OF ORONO PERMIT NO.: 2010-00275 <br /> , 2'750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEn: OS/05/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4160 FOREST LAKE DR <br /> PIN : 07-117-23-11-0003 <br /> LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEF[NED <br /> VALUATION : $ 8,669.00 <br /> NOTE: TEAI2 OFF AND RGROOF HOUSE AND GARAGE <br /> APPLICANT PERMIT FEE SCHEDULE 177.00 <br /> WALKER ROOFING CO., INC. STATE SURCHARGE(VALUATION) 4.33 <br /> 2274 CAPP RD <br /> MN 55104- MISC FEE 0.00 <br /> O MA[L-IN FEE 2.00 <br /> Minnesota State License#: 4229 TOTAL 183.33 <br /> OWNER <br /> GOLDEN, LYNN &TIMOTHY <br /> 4160 FOREST LAKE DR <br /> MOUND, MN 55364 <br /> AGREEMENT A1vD SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 separatc <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 Sta[e Building Code.This permit may bc <br /> revoked at any[ime fo`due cause. <br /> `%�L(.Q.l..� !� l l l l <br /> Applicant Permitee Signature Date Issued B ignature D <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />