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! " CITY OF ORONO * 2 0 1 5 - 0 1 3 9 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/29/2015 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 365 FERNDALE RD N <br /> PIN : 36-118-23-41-0002 <br /> LEGAL DESC : LTNPLATTED 36 l 18 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING- UNDEFINED <br /> VALUATION : $ 2,500.00 <br /> NOTE: REPLACE(1)WINDOW INTO EXISTING OPENING <br /> APPLICANT PERMIT FEE SCHEDULE 92.93 <br /> STATE SURCHARGE(VALUATION) 1.25 <br /> THOMPSON CONSTRUCTION LLC TOTAL 94.18 <br /> 505 COUNTY ROAD 19 Payment(s) <br /> MOLJND, MN 55364- CREDIT CARD 2641 94.18 <br /> (952)393-5349 <br /> Minnesota State License#: BUIL-BC686985 <br /> OWNER <br /> TERRILL, DONALD&KIMBERLY <br /> 365 FERNDALE RD N <br /> WAYZATA, 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 permit is for only the work described and does <br /> no[grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whe[her or not specified herein.This permi[will <br /> expire and become null and void if construc[ion au[horized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of l80 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 permi[may be <br /> revoked at any time for due cause. <br /> �� /B�'e2��'��� ��1� l� l 1—_J <br /> Applicant Permitee Sig re Date Issued y ignature Date <br />