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CITY OF ORONO II <1 II111111I 11111111111u <br /> 04 - 0358 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/21/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4100 ELM ST <br /> PIN : 06-117-23-41-0060 <br /> LEGAL DESC : MINNETONKA SUMMIT PARK <br /> : LOT 000 BLOCK 007 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : 0/S BUILDING -UNDEFINED <br /> VALUATION : $ 1,500.00 <br /> NOTE: EGRESS WINDOW AND WELL <br /> APPLICANT PERMIT FEE SCHEDULE 57.50 <br /> REVAMP REMODELING& DESIGN STATE SURCHARGE(VALUATION) 0.75 <br /> 105 NEW ENGLAND PLACE#145 MAIL-IN FEE 2.00 <br /> STILLWATER, MN 55082- TOTAL 60.25 <br /> Minnesota State License#: BUIL-BC634654 Payment(s) <br /> CREDIT CARD 0524 60.25 <br /> OWNER <br /> CARROLL,MR&MRS THOMAS <br /> 4100 ELM ST <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <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 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 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 /> ii/2_///)/ <br /> 1 // / 21 / /7 <br /> Applicant Permitee Signature Da lss d By Signature nature Date <br />