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'' y CITY OF ORONO PERMIT NO.: 2010-00917 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �SSUEn: 09/30/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 635 FERNDALE RD N <br /> PIN : 36-118-23-11-0009 <br /> LEGAL DESC : LJNPLATTED 36 l l8 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 30,000.00 <br /> NO"I'E: TGAR OFF REROOF-ASPHALT SHINGLES <br /> APPLICANT PERMIT FEE SCHEDULE 466.75 <br /> ALLSTAR CONSTRUCTION STATE SURCHARGE(VALUATION) 15.00 <br /> 5145 INDUSTRIAL ST <br /> SUITE 103 TOTAL 481.75 <br /> MAPLE PLAIN, MN 55359 <br /> (763)479-8700 <br /> Minnesota State License#:20631575 <br /> OWNER <br /> O'NEILL-JACOBSEN, LARRY JACOBSON&VICTORIA <br /> 635 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 approvcd plans and spccifications,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 goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void ifconstruction 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 co formance with the State E3uilding Code.This permit may be <br /> revoke t�ny 'm for u cause. <br /> � � / �" � �'� � <br /> npplicant Permitee Signature Datc ���� �� <br /> Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />