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� CITY OF ORONO PERMIT NO.: 2010-00928 <br /> i <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/04/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1965 COUNTRY CLUB RD <br /> PIN : 27-118-23-42-0020 <br /> LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN <br /> : LOT 002 BLOCK 003 <br /> PERMIT TYPE : MINOR ALTERATIONS � <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 12,000.00 <br /> NO TE: TL'AR OFF REROOF-ASPE IALT SHINGLI=,S <br /> APPLICANT PERMIT FEE SCHEDULE 221.25 <br /> FOSS EXTERIORS LLC STATE SURCHARGE(VALUATION) 6.00 <br /> 1891 SANDBAR CIRCLE TOTAL 227.25 <br /> WACONIA, MN 55387 <br /> (612)229-8619 <br /> Minnesota State License#: 20438042 <br /> OWNER <br /> MONDALE-CONNOR, PATRICIA <br /> 1965 COUNTRY CLUB RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> Che work for which this permit is issued shall be performed accordin�to <br /> the approvcd plans and specitications_applicable City approvals,and the <br /> State 13uilding Code. This permit is for onl��the work described and does <br /> not grant pennission for additional or related work which requires scparate <br /> pennits. All provisions of laws and ordinances goveming this type of�vork <br /> shall be compied with whelher or not specitied herein."I�his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced 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 /> I�he applicant is re nsible for assuring all required inspections are <br /> requested in conf r ance with the State Building Code.This permit may be <br /> revoked at any t� or e c• se. <br /> C ��l � l �� ��l �l l� <br /> npplicant P mitee Signature Date Issue y Signature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />