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, CITYOFORONO * z0 14 — PJ0380 � <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 04/28/2014 <br /> ° ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4030 DAHL RD <br /> PIN : 07-117-23-11-0022 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT 018 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTNITY : O/S BUILDING - UNDEFINED <br /> VALUATION : $ 17,678.00 <br /> NOTF,: RI:VLAC� 10 WINDOWS AND 1 PA"CIO DOOR WI"I�HIN EXISTING OPF.N[NGS <br /> APPLICANT PERMIT FEE SCHEDULE 309.75 <br /> STATE SURCHARGE(VALUATION) 8.84 <br /> RENEWAL BY ANDERSON MAIL-IN FEE 2.00 <br /> 1920 COUNTY RD C. WEST <br /> ROSEVILLE, MN 55113 TOTAL 320.59 <br /> (612)502-4777 Payment(s) <br /> Minnesota State License#: BUIL-BC130983 CREDIT CARD 8788 320.59 <br /> OWNER <br /> GfLBERT, JAMES& MARY <br /> 4030 DAHL RD <br /> MOUND, MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable Ciry approvals,and the <br /> Sta[e 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 whether or not specitied 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 after 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 any time for due cause. <br /> I`�1�K.1/Ci / / <br /> Applicant Permitee Signature Date Issued I3 ignature Date <br />