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CITY OF ORONO PERM[T NO.: 2010-01097 <br /> ... 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE Iss[1En: 1U09/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRGSS : 865 FERNDALE RD N <br /> PIN : 25-118-23-44-0002 <br /> LEGAL DESC : UNPLATTED 25 1 18 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : REL[GIOUS <br /> CONSTRUCTION TYPE : ROOF[NG-ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 78,000.00 <br /> NOTF;: TGAR OI'1'RGROOP-}�LASI�ING <br /> APPLICANT PERMIT FEE SCHEDULE 891.75 <br /> PETE TACHENY ROOFING& SIDING INC STATE SURCHARGE(VALUATION) 39.00 <br /> 49 SOUTH OWASSO BLVD <br /> LITTLE CANADA, MN 551 l7- TOTAL 930.75 <br /> (651)484-4744 <br /> Minnesota State License#: 20630076 <br /> OWNER <br /> CHURCH, ST. EDWARDS EPISCOPAL <br /> 865 FERNDALE RD N <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> I'he work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State[3uilding Code. 7'his perniit is for only the work described and does <br /> not grant permission 1or 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 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 wark has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> re t in conformance with the State Building Code.This permit may be <br /> r o a an e for due cause. <br /> i l 0 /�i l /D <br /> A plica Permitce Signature Date Is By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />