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CITY OF ORONO * Z 0 1 3 - 0 P1 9 5 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/30/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 258 CYGNET PL <br /> PIN : 04-117-23-23-0019 <br /> LEGAL DESC : SWAN LAKE ADDN <br /> : LOT O10 BLOCK 003 <br /> PERM(T TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCT[ON TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATION : $ 2,900.00 <br /> NO"I�F.: I;GRESS SLID]:R <br /> APPLICANT PERMIT FEE SCHEDULE 88.50 <br /> EGRESS WWDOW GUY STATE SURCHARGE(VALUATION) 1.45 <br /> 3410 KILMER LANE N <br /> PLYMOUTH, MN 55441- MAIL-IN FEE 2.00 <br /> (763) 544-2775 TOTAL 91.95 <br /> Minnesota State License#: BC665399 <br /> OWNER <br /> HUBQARD, ANNIE <br /> 258 CYGNET PL <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pennit is issued shall be performed according to <br /> the approved plans and specifications,applicablc City approvals,and Uie <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 goveming this type of work <br /> shall be compied with whether or not specified herein.This permi[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 cominenced. <br /> l�he applicant is responsible for assuring all required inspections are <br /> requested in contormance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ���c.�--�-Le�� —�1-����� , C�- t y ���� � �_3 <br /> A licant Permitec Si nature Date � <br /> �p � Iss By Signaturc Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />