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CITY OF ORONO PERMIT NO.: 2010-00834 <br /> � • 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE �SSUED: 09/14/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4650 CREEKWOOD TR <br /> PIN : 30-118-23-33-0006 <br /> LEGAL DESC : PAINTERS WOODS <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 15,000.00 <br /> NOT�: TEAR OFF RLROOF-ASPHALT SI IINGLES <br /> APPLICANT PERMIT FEE SCHEDULE 265.50 <br /> PROVIDENCE CONSTRUCTION STATE SURCHARGE(VALUAT[ON) 7.50 <br /> 16850 144TH STREET N <br /> MARINE ON THE ST CROIX, MN 55047- TOTAL 273.00 <br /> (612)590-6930 PAID WITH CC# 9386 <br /> Minnesota State License#: 20626630 <br /> OWNER <br /> BJORK, KEVIN &LORI <br /> 4650 CREEKWOOD TR <br /> MAPLE PLAIN, MN 55359 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall bc performed according to <br /> the approved plans and specitications,applicable City approvals,and thc <br /> State Building 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 governing this type of work <br /> shall be compied with whcther or not specified herein.This permit will <br /> cxpire and become null and void if construction authorized is not r <br /> conunenced within 180 days ofthe date of issuance,or iCconstruction is <br /> suspended for a period ot�I 80 days at any time after work has commenced. <br /> "I�he applicant is responsible for assuring all required inspections are <br /> requcstcd in confomiance with the State Building Code.This permit may be <br /> revoke any time for due cause. <br /> � � � � � ��U / � / �� <br /> Applicant Permi Signature Date Iss e y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />