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,� CITY OF ORONO PERMIT NO.: 2011-00326 <br /> 2750 KELLEY PARKWAY <br /> , ORONO, MN 55356- nATE lssuEn: OS/1U2011 <br /> i <br /> , (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 781 BOULDER DR <br /> PIN . 33-118-23-11-0008 <br /> LEGAL DESC : STONEBAY <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : M[NOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 8,000.00 <br /> NOTI?: TGAR OFF REROOI' <br /> I <br /> APPLICAI�IT <br /> PERMIT FEE SCHEDULE 162.2� <br /> MIDWEST ROOFING STATE SURCHARGE(VALUATION) 4.00 <br /> � 6541 SYCAMORE CT N <br /> MAPLE GROVE, MN 55369- TOTAL 16625 <br /> � (763)427-9696 <br /> Minnesota State License#: 20637010 <br /> OWNER <br /> KAYSER, MICHEAL& PATRICIA <br /> 781 BOULDER DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for���hich this permit is issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State[3uilding 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 /> 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 conunenced. <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 t y time e cause. <br /> � �� 1� � ll �� � � <br /> Ap icant Permitee Signature Date Issue By Signature Date � <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />