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� ' ' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 6 — 0 1 3 6 2 * <br /> DATE ISSUED: 10/26/2016 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1540 LONG LAKE BLVD <br /> PIN : 26-118-23-33-0007 <br /> LEGAL DESC : ALBEES LONG LAKE ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DOORS <br /> ACTIVITY : O/S BUILDING-LJNDEFINED <br /> VALUATION : $ 3,230.00 <br /> NOTE: DOOR REPLACEMENT <br /> APPLICANT PERMIT FEE SCHEDULE 10838 <br /> PELLA NORTHLAND STATE SURCHARGE(VALUATION) 1.62 <br /> 15300 25TH AVE N.-SUITE# 100 1vIAIL-IN FEE 2.00 <br /> PLYMOUTH,MN 55447- TOTAL 112.00 <br /> (952)345-6047 Payment(s) <br /> Minnesota State License#:BUIL-BC645090 CHECK 76317 112.00 <br /> OWNER <br /> GHANDY&RACHEL CARPENTER,WILLIAM <br /> 1540 LONG LAKE BLVD <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 pertnission for additiona!or related work which requires separate <br /> pertnits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified hereia 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 or due cause. <br /> . � <br /> - �` oV O� �/� <br /> Applicant P mitee Signature Date Issued By S' ature Date <br />