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CITY OF ORONO PERMIT NO.: 20�0-00302 <br /> , ' 2750 KELLEY PARKWAY <br /> f ORONO, MN 55356- DATE IssUED: OS/1U2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRES� : 785 FERNDALE RD N <br /> PIN : 36-118-23-11-0012 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1031 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : M(NOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUiLDING-UNDEFINED <br /> VALUATION : $ 6,218.00 <br /> NOTE: REPLACE(2)WWDOWS AND(I)PATIO DOOR WITHIN�XISTING OPFNINGS <br /> APPL[CANT PERMIT FEE SCHEDULE 147.50 <br /> RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 3.11 <br /> 1920 COUNTY RD C. WEST <br /> ROSEVILLE, MN 551 13 MAIL-]N FEE 2.00 <br /> (612)502-4777 TOTAL 152.61 <br /> Minnesota State License#: 20130983 <br /> 1 <br /> L <br /> OWNER <br /> CULLUM JR, M[CHELLE&THOMAS <br /> 785 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 /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specificd 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 atter 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 time fqr due cause. <br /> i��� �lC, / / (!j�i/I�1,� l l <br /> �.,--�� <br /> Applicant Permitee Signature Date Issued B ignature � ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />