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!� <br /> f . CITY OF ORONO rE�iT No.: 2010-00637 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE IssuEn: 07/28/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 335 HOLLANDER RD <br /> PIN : 25-118-23-43-0009 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1429 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-CEDAR <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 35,000.00 <br /> APPLICANT pERMIT FEE SCHEDULE 520.50 <br /> GIERTSEN COMPANY STATE SURCHARGE(VALUATION) 17.50 <br /> 8385 lOTH AVE N <br /> GOLDEN VALLEY,MN 55427- MISC FEE 0.00 <br /> (763)546-1300 TOTAL 538.00 <br /> Minnesota State License#: 1796 PAID WITH CC# ,1•7�'U <br /> ?�'g'� <br /> OWNER <br /> ERICKSON,WALTER&NANCY <br /> 335 HOLLANDER RD <br /> WAYZATA,MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perforrned 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 sepazate <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 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 /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued B ignature D te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />