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�M'� � <br /> CITY OF ORONO * z 0 1 4 - 0 1 1 1 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/30/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 800 FOREST ARMS LA <br /> PIN : 07-117-23-12-0004 <br /> LEGAL DESC : FOREST ARMS <br /> : LO"T' 001 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATION : $ 30,000.00 <br /> NO�I�E: RI;PI,�CI? WINDOWS INTO F,XIS'fING OPGNINGS. <br /> APPLICANT PERMIT FEE SCHEDULE 466.75 <br /> STATE SURCHARGE(VALUATION) 15.00 <br /> A 1 RESTORATION TOTAL 481J5 <br /> 4720 XENE LN Payment(s) <br /> PLYMOUTH, MN 55446- CHECK 7501 481.75 <br /> Minnesota State License#: BUIL-BC680725 <br /> OWNER <br /> MAYES, CLIFFORD A& BRF.NDA L <br /> 800 FOREST ARMS LA <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> I'he�vork for which this pcnnit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State[3uilding Code. 'l�his 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 speciYied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date ot�issuance,or if construclion is <br /> suspended for a period of 180 days at any time aRer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> rcquested in conformance with thc State Building Code.This permit may be <br /> revoked at any time ti�r due cause. <br /> �. <br /> �> __ �� � �r� � � i� <br /> ____ - �,� ; , <br /> „ , <br /> -� _ .__ : �-- __ � � <br /> � pplicant Permitee Signature Datc Iss � I3y Signature Date <br />