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CITY OF ORONO 0 I 1 if 1 Ill II II 1111111 I Il <br /> 2750 KELLEY PARKWAY * 2 T 13 - 0081S <br /> DATE ISSUED: 08/19/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1801 WEST FARM RD <br /> PIN : 27-118-23-44-0019 <br /> LEGAL DESC : N/A <br /> : LOT MB BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SIDING <br /> ACTIVITY : 0/S BUILDING-UNDEFINED <br /> VALUATION : $ 24,396.00 <br /> NOTE: WINDOW REPLACEMENT AND SIDING FROM STORM DAMAGE <br /> APPLICANT <br /> GIERTSEN COMPANY PERMIT FEE SCHEDULE 413.00 <br /> 8385 10TH AVE N STATE SURCHARGE(VALUATION) 12.20 <br /> GOLDEN VALLEY, MN 55427- TOTAL 425.20 <br /> (763)546-1300 PAID WITH CC# 1523 <br /> Minnesota State License#: BC 1796 <br /> OWNER <br /> MULDOON,PAUL& SAMANTHA <br /> 1801 WEST FARM RD <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 inspections are <br /> requested in conforri1 nce with the St e Building Code.This permit may be <br /> revoked at any time for with <br /> Applicant Permitee Signature Date <br /> Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />