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R <br /> ' ' CITY OF ORONO * 2 0 1 6 - 0 1 z z 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/29/2016 <br /> ORONO,NIN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4041 NORTH SHORE DR <br /> PIN : 07-117-23-44-0077 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1420 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-LJNDEFINED <br /> VALUATION : $ 5,326.00 <br /> NOTE: REPLACE(2)WINDOWS WITHIN EXISTING OPENINGS. <br /> APPLICANT PERMIT FEE SCHEDULE 13936 <br /> STATE SURCHARGE(VALUATION) 2.66 <br /> RENEWAL BY ANDERSON TOTAL 142.02 <br /> 350 73RD AVE NE Payment(s) <br /> FRIDLEY,MN 55432 CREDIT CARD 8788 142.02 <br /> (612)502-4777 <br /> OWNER <br /> MCCURDY,DALE <br /> 4041 NORTH SHORE DR <br /> MOUND,MN 55364 <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. T'his permit is for only the work described and does <br /> not grant permission for addirional 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 construcNon authorized is not <br /> commenced within 1 SO 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 asswing all required inspections are <br /> requested in conforcnance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> C �/��/ �� <br /> Applicant Permitee Signature Date Issued Signature Date <br />