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� CITY OF ORONO <br /> �" * 2 0 1 3 — 0 1 1 3 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4025 DAHL RD <br /> PIN : 07-117-23-14-0002 <br /> LEGAL DESC : UNPLATTED 07 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPF. : SIDING <br /> ACTIVITY : O/S BUILDING - UNDEF[NED <br /> VALUATION : $ 3,000.00 <br /> NO"TL: RESIDING <br /> APPLICA1vT PERMIT FEE SCHEDULE 88.50 <br /> MIDWEST EXTERIORS PLUS STATE SURCHARGE(VALUATION) 1.50 <br /> 6451 SYCAMORE CT. N. TOTAL 90.00 <br /> MAPLE GROVE, MN 55369- <br /> Minnesota State License#: BC010277 <br /> OWNER <br /> JOHNSON&JODI QUAM-JOHNSON, DEAN <br /> 4025 DAHL RD <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The���ork for which this pennit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission ibr additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specitied hcrein.'I'his 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 ar[er work has commenecd. <br /> The applican[is responsible for assuring all required inspections are <br /> requested in conformance wi[h the S[ate Building Code.This permit may be <br /> revo ed a ny time r due cau e. <br /> � <br /> �u� a 3� /� � /D ��3 � <br /> �App ntP' mitee Signaturei Datc Issu� By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER TNAN DESCRIBED ABOVE. <br />