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` CITY OF ORONO PERMIT NO.: 2011-00436 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEn: 06/08/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4680 NORTH ARM DR W <br /> PIN : 06-117-23-23-0006 <br /> LEGAL DESC : UNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 16,000.00 <br /> NOTE: TEAR OFF REROOF <br /> APPLICANT PERMIT FEE SCHEDULE 280.25 <br /> GIERTSEN COMPANY <br /> 8385 IOTH AVE N STATE SURCHARGE(VALUATION) 8.00 <br /> GOLDEN VALLEY, MN 55427- TOTAL 288.25 <br /> (763)546-1300 PAID WITH CC# 9298 <br /> Minnesota State License#: 1796 <br /> OWNER <br /> WESTFALL, MYRON&PATRICIA <br /> 4680 NORTH ARM DR W <br /> MOUND, MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according[o <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 /> no[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 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 the St e Building Code.This permit may be <br /> revoke an ime for e use. n <br /> � / � / �/ �,� '�� � �� �� <br /> pplicant Per itee Signature Date Issue�' y Signatu Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />