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� � CITY OF ORONO * z 0 1 3 - 0 1 1 6 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1 U01/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3420 BAYSIDE RD <br /> PIN : OS-117-23-13-0012 <br /> LEGAL DESC : AUDITOR'S SUBD. NO.203 <br /> : LOT 020 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERAT[ONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 3,275.00 <br /> APPLICANT pERMIT FEE SCHEDULE 103.25 <br /> STANDARD WATER CONTROL SYSTEMS INC STATE SURCHARGE(VALUATION) 1.64 <br /> 5337 LAKELAND AVE N <br /> BROOKLYN CENTER, MN 55429- MA1L-IN FEE 2.00 <br /> Minnesota State License#: BC001522 TOTAL 106.89 <br /> PAID WITH CC# 2666 <br /> OWNER <br /> MILESKI& APRIL NEWTON, BLAIR <br /> 3420 BAYSIDE RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work Cor which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State[3uilding 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 afrer 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 for,slue cause. <br /> /Vl (�.(�Y � � / / <br /> Applicant Pe mitee Signa ure Date Issued y S� ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A UE. <br />