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a <br /> CITY OF ORONO * z 0 1 z - 0 1 0 3 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/15/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 980 COX FARM RD <br /> PIN : 27-118-23-33-0012 <br /> LECAL DESC : SHADOWOOD FARM <br /> : LOT 009 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : W[NDOWS <br /> ACTNITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 12,629.00 <br /> NOTL': WINDOW REPLACEMENT <br /> APNLICANT PERMIT FEE SCHEDULE 236.00 <br /> SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 6.31 <br /> 10751 EXCELSIOR BLVD <br /> HOPKINS, MN 55343 MAIL-IN FEE 2.00 <br /> (952)277-1600 TOTAL 244.31 <br /> Minnesota State License#: BC239369 PA[D WITH CC# 3989 <br /> OWNER <br /> WILLSON, CHRIS& SARAH <br /> 980 COX FARM RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pennit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This pennit is for only the work described and does <br /> not grant permission Yor additional 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 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 atter 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 at a � ie for due c e. <br /> /v� /S�/Z <br /> Applica t Permitee Signatu�� Date ��� �`'� � � <br /> Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />