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CITY OF ORONO PERMIT NO.: 2009-00793 <br /> _ 2750 KELLEY PARKWAY <br /> t ORONO, MN 55356- �ATE �SSUEn: 1U06/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 259 HOLLANDER RD <br /> PIN : 25-118-23-43-0017 <br /> LEGAL DESC : HOLLY ACRES <br /> : LOT 004 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING-LJNDEFINED <br /> VALUATION : $ 20,000.00 <br /> APPLICANT PERMIT FEE SCHEDULE 33925 <br /> MAINTENANCE FREE MINNESOTA, INC. STATE SURCHARGE(VALUATION) 10.00 <br /> 4741 UNIVERSITY AVE NE <br /> COLUMBIA HEIGHTS, MN 55421- TOTAL 349.25 <br /> (763)560-4037 <br /> OW1vER <br /> PIERCE, STEVEN& KATHER[NE <br /> 259 HOLLANDER RD <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 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 wi[h whether or no[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 /> re y i r due cause. �� , ` � /lj„ ��� <br /> � J/ VKl <br /> �� , �� , o , yn � � <br /> y�.��,�,��� � � � � <br /> Applica t Permitee Signature Date Issued By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />