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w ' CITY OF ORONO PERMIT NO.: 2011-00325 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: OS/11/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 783 BOULDER DR <br /> P[N : 33-118-23-11-0009 <br /> LEGAL DESC : STONEBAY <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATION : $ 8,000.00 <br /> NOTE: TEAR OFF RL'ROOF <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 16225 <br /> MIDWEST ROOFING STATE SURCHARGE(VALUATION) 4.00 <br /> 6541 SYCAMORE CT N <br /> MAPLE GROVE, MN 55369- TOTAL 166.25 <br /> (763)427-9696 <br /> Minnesota State License#: 20637010 <br /> OWNER <br /> TRUSTEE, MARGHERITA GALE HARRIS <br /> 783 BOULDER DR <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��ork described and does <br /> not grant permission for addifional 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 specif ied herein.This permit will <br /> expire and become null and void if construction authorized is no[ <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 t any ume for due cause. <br /> � �� � / � �� (� C�7��t.C�.l� � � // l l/ <br /> App icant Permitee Signature Date Issue y Signat�ire Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />