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CITY OF ORONO * Z 0 1 Z - PJ 0 6 2 8 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 07/02/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 129 CHEVY CHASE DR <br /> PIN : 36-ll 8-23-41-0020 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT O15 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACT[VITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 1,486.00 <br /> NOTE: REPLACE ONE WINDOW IN EXISTING OPGNING <br /> APPLICANT PERMIT FEE SCHEDULE 57.50 <br /> SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 0.74 <br /> 10751 EXCELS[OR BLVD <br /> HOPKINS, MN 55343 MAIL-[N FEE 2.00 <br /> (952)277-1600 TOTAL 60.24 <br /> Minnesota State License#: BC239369 PAID WITH CC# 3989 <br /> OWNER <br /> SAHLSTROM, DAVID&JEAN <br /> 129 CHEVY CHASE DR <br /> ,MN 55391- <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 pennit is for only[he work described and does <br /> no[grant permission for additional or related work which requires separate <br /> permits. Ali 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 conformance with the State Building Code.This permit may be <br /> revoked at any[ime foFdue cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Sig ure Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />