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CITY OF ORONO PERMIT NO.: 2010-00969 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE [ss[1En: 10/11/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2515 COUNTRYSIDE DR <br /> P 1 IV : 04-117-23-11-0007 <br /> LEGAL DESC : COUNTRYSIDE MANOR <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : SIDING <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 30,000.00 <br /> NO"I'E: "CHIS PERMI"1'INCLUDES SIDING. RGROOFING, DECK RESURFACING, WINDOWS,DOOR <br /> APPLICAIYT PERMIT FEE SCHEDULE 466J5 <br /> BUILDERS BY DESIGN STATE SURCHARGE(VALUATION) 15.00 <br /> 21185 VIKING BLVD. <br /> WYOMING, MN 55092- TOTAL 481J5 <br /> Minnesota State License#: 20026555 <br /> OWNER <br /> KAHLER,CHRIS& DELPHINE <br /> 2515 COUNTRYS[DE DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The���ork for evhich this permit is issued shall be performed according to <br /> thc approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This pemlit 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 governing[his 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 I 80 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 H�it e State Building Code.This permit may be <br /> revoked at an� � � ause. <br /> -�— `— / / / / <br /> pplic t Permitee Signature Date Issued B ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />