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,� � CITY OF ORONO * 2 0 1 3 - PJ 0 7 9 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/13/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 25 BROWN RD S <br /> PIN : 03-117-23-21-0001 <br /> LEGAL DESC : UNPLATTED 03 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CHIMNEY- REPAIR <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATION : $ 12,090.00 <br /> NO"I�I:: REMOVING FLUI�i'I�ILES AND INS"1'ALL[NG STAINLESS STEEL LINER. <br /> APPLICANT PERMIT FEE SCHEDULE 236.00 <br /> NICK RICHARDSON STATE SURCHARGE(VALUATION) 6.05 <br /> 4179 149TH AVE NW <br /> ANDOVER, MN 55304- TOTAL 242.05 <br /> (612)207-8619 PAID WITH CC# 5822 <br /> Minnesota State License #: BC183369 <br /> OWNER <br /> POWERS, SUSAN <br /> 25 BROWN RD S <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for���hich this permit is issued shall be performed according to <br /> the approved plans and specifications,applicablc City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not gran[permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this typc 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 with Ihe State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> •�����,��/ 1� /�,-ol 3 �� � / �� / I <br /> Applicant Permitee Signature Date Issu B Si nature Date <br /> Y� & <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />