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CITY OF ORONO PERMIT NO.: 20ll-00466 <br /> _ � 2750 KELLEY PARKWAY <br /> ' ORONO, MN 55356- �ATE ISSUEn: 06/16/2011 <br /> �� 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 565 FERNDALE RD N <br /> PIN : 36-118-23-14-0004 <br /> LEGAL DESC : UNPLATTED 36 1 18 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCT[ON TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 9,000.00 <br /> APPLICANT PERMIT FEE SCHEDULE ]77.00 <br /> LADWALK INC. STATE SURCHARGE(VALUATION) 4.50 <br /> 417 N. PRARIE TOTAL 181.50 <br /> LAKE CITY, MN 55041- <br /> (651)490-5900 PAID WITH CC# 8451 <br /> Minnesota State License#: 20578323 <br /> OWNER <br /> MARTIN,JERRY&JANICE <br /> 565 FERNDALE RD N <br /> WAYZATA, MN 55391 <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 Ciry 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 80 days at any time after work has commenced. <br /> The appl s ons I r uring all required inspections are <br /> ti in co o a c i the ate Building Code.This permit may be � i/G/�J� <br /> reYoke any e d c us� �� �� <br /> (q , ��, Q�. C� C G�'l'�'c�''I � ��, 4"���, <br /> � pplicant Permit � na re Date Issued By Signature Date <br /> S TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />