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CITY 0 ORONO PERMIT NO.: 2009-00858 <br /> 2750 KELLE PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 11/30/2009 <br /> (9$2) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 505 OLD CRYSTAL BAY RD S <br /> PIN : 04-117-23-31-0003 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.230 <br /> : LOT 022 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTIVITY : 0/S BUILDING-UNDEFINED <br /> VALUATION : $ 7,000.00 <br /> NOTE: TEAR OFF REROOF <br /> APPLICANT PERMIT FEE SCHEDULE 147.50 <br /> NORDKAP CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 3.50 <br /> 1881 STATION PARKWAY TOTAL 151.00 <br /> ANDOVER,MN 55304- <br /> (763)607-4845 <br /> Minnesota State License#:20635312 <br /> OWNER <br /> HARMANN,DAVID&MONA <br /> 505 OLD CRYSTAL BAY RD S <br /> LONG LAKE,MN 55356 <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 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 inspeptions are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / 3� / O9 adja // /30/Oy <br /> Applicant Permitee Signature Date Issu d y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />