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� - �` - CITY OF ORONO PERMIT NO.: 2010-00916 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE �ssuEu: 09/30/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3300 FOX ST <br /> PIN : OS-117-23-44-0003 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1358 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : M[NOR ALTERAT[ONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOF[NG-CEDAR <br /> ACT[VITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 60,000.00 <br /> NOTE: TEAR OFF RGROOP-CEDAR SHAKGS <br /> APPLICANT PERMIT FEE SCHEDULE 756.75 <br /> TOM TOTALL ROOFING STATE SURCHARGE(VALUATION) 30.00 <br /> 16176 H[LLTOP RD <br /> EDEN PRAIRIE, MN 55347- TOTAL 786.75 <br /> (952)975-0982 PAID WITH CC# 8816 <br /> Minnesota State License#: 20035577 <br /> OWNER <br /> TRUBECK, WILLIAM&JUD[TH <br /> 3300 FOX ST <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> Che work for which lhis permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and thc <br /> State Building Codc. "I'his permit is for only the work described and does <br /> not grant permission tor 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 /> cxpire and become null and void if construction authorized is not <br /> commenced within l80 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 resp ible for assuring all required inspections are <br /> requested in confo ance with the Sta[e Building Code.This permit may be <br /> revoked at an � e � cause. <br /> �� � � ��r�� ��� i� <br /> Ap � ermitee Signaturc Date Is By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />