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CITY OF ORONO * 2 PJ 1 3 - 0 0 4 9 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/17/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 980 FERNDALE RD W <br /> PIN : 02-117-23-44-0019 <br /> LEGAL DESC : COUNTRY CLUB ESTATES <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATION : $ 17,237.00 <br /> NOTE: WINDOW REPLACf;M1�,N"I� <br /> APPLICANT PERMIT FEE SCHEDULE 309.75 <br /> APEX ENERGY SOLUTIONS STATE SURCHARGE(VALUATION) 8.62 <br /> 8400 NORMANDALE LAKE BLVD#920 <br /> BLOOMINGTON, MN 55431- MAIL-IN FEE 2.00 <br /> (651)688-2739 TOTAL 32037 <br /> PAID WITH CC# 5542 <br /> OWIVER <br /> SAFAR, JACK& PAMELA <br /> 980 FERNDALE RD W <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perYormcd according to <br /> [he 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 goveming 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 atter 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 li�r due cause. <br /> ��'�'�i a%(��G�� �i /7 i ,(� �_ l � � � <br /> Applicant Permitee Signature Dalc Issue Si nature Date <br /> y. g <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />