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CITY OF ORONO PERMIT NO.: 2011-00320 <br /> • 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUED: OS/10/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> , ADDRESS : 767 BOULDER DR <br /> PIN : 33-118-23-11-0006 <br /> '', LEGAL DESC : STONEBAY <br /> : LOT 003 BLOCK 001 <br /> ' PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACT[VITY : O/S BUILD[NG -UNDEFINED <br /> VALUATION : $ 8,000.00 <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 162.25 <br /> MIDWEST SIDING ROOFING & W[NDOWS STATE SURCHARGE(VALUATION) 4.00 <br /> 6451 SYCAMORE CT N <br /> MAPLE GROVE, MN 55369- TOTAL 166.25 <br /> Minnesota State License#: 20010277 <br /> OWNER <br /> GARDINER, PATRIC[A <br /> 767 BOULDER DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pernlit is issued shall be performed accordinc to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Building Code, This permit is for only the work described and docs <br /> no[gran[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 wi[h whether or not specified herein.This pemiit will <br /> expire and become null and void if construction authorized is not <br /> commcnced within l80 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 arc <br /> requested in conformance with the State[3uilding Code.'Chis permit may be <br /> revoked a y ti ie � ue cause. <br /> - `Zl� � l'� O � � <br /> , Applicant Permitee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABOVE. <br />