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CITY OF OR NO PERMIT NO.: 2011-00381 <br /> 2750 KELLEY PA WAY <br /> ORONO, MN 55 56- DATE ISSUED: OS/23/2011 <br /> � 952 249-4600 FAX: 9 2 249-4616 <br /> ADDRESS : 4105 BAYSIDE RD <br /> �� P[N : 06-117-23-14-0023 <br /> LEGAL DESC : BAYSIDE RIDGE <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCT[ON TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUAT[ON : $ 18,000.00 <br /> APPLICANT PERMIT FE SCHEDULE 309.75 <br /> AC CONSTRUCTION & RESTORATION SERV <br /> 5 HIGHWAY 55 W STATE SUR HARGE(VALUATION) 9.00 <br /> BUFFALO, MN 55313- MISC FEE 0.00 <br /> (763)682-0770 TOTAL 318.75 <br /> Minnesota State License#: 20634132 I <br /> OWNER <br /> BURKE,NICK& SUE <br /> 4105 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <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 goveming 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 /> commcnced within 180 days of tl�e 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 /> revoke at any time for due cause. <br /> � Gv �S ��-- � l� � � <br /> Applica t Permitee Signature Date Issued By ig t re Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />