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CITY OF ORONO PERMIT NO.: 2011-00483 <br /> , • 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSVE�: 06/17/20ll <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3500 BAYSIDE RD <br /> PIN : OS-117-23-13-0015 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT 024 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERAT[ONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-CEDAR <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 50,000.00 <br /> APPLICANT PERMIT FEE SCHEDULE 681 JS <br /> MN ROOFING&REMODELING STATE SURCHARGE(VALUATION) 25.00 <br /> 6260 LAKELAND AVE.N. <br /> BROOKLYN PARK, MN 55428- MISC FEE 0.00 <br /> ��63)zog-�8i9 TOTaL �o6.�s <br /> Minnesota State License#: 3983 PAID WITH CC# 5024 <br /> OWNER <br /> BANGERT, MR. & MRS. <br /> 3500 BAYSIDE 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 Yor 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 hetein.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 /> revoked at any time for due cause. <br /> /�`' � � / / <br /> Ap ican Permitee Signature Date Issued By gnature ate <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />