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� CITY OF ORONO PERMIT NO.: 2011-00454 <br /> � � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuED: 06/13/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4565 BAYSIDE RD <br /> PIN : 06-117-23-21-0005 <br /> LEGAL DESC : UNPLATTED 06 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -CEDAR <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 23,545.00 <br /> NOTE: TEAR OFF REROOF-CEDAR SHAKE ROOF <br /> APPLICANT PERMIT FEE SCHEDULE 398.25 <br /> ROOF COMPANY NA INC. STATE SURCHARGE(VALUATION) 11.77 <br /> 5565 QUAM AVE NE <br /> ST MICHAEL,MN 55376- TOTAL 410.02 <br /> (763)550-0444 <br /> Minnesota State License#: 20172153 <br /> OWNER <br /> RENNEBOHM, PETER& SHARON <br /> 4565 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be performed according lo <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permi[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 bewme null and void if cons[ruction authorized is not <br /> commenced within (80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 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 /> revoked at y ' f e us <br /> , ` i %3i / � <br /> � A icant Permitee Signature Date � �� ���� �� � �� � � <br /> Iss'u By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />