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CITY OF ORONO PERMIT NO.: 2009-oo�s6 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO,MN 55356- DATE IssuEn: 1 U04/2009 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2750 KELLY AVE <br /> PIN : 21-117-23-23-0038 <br /> LEGAL DESC : VERN-MAR MANOR <br /> : LOT 013 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 6,500.00 <br /> NOTE: TEAR OFF REROOF <br /> APPLICANT pERMIT FEE SCHEDULE 147.50 <br /> KURT THOMAS CONSTRUCTION STATE SURCHARGE(VALUATION) 3.25 <br /> 1811 EASTLAND CIRCLE NE TOTAL 150.75 <br /> BUFFALO,MN 55313- <br /> (763)807-2489 PAID WITH CC# 4812 <br /> Minnesota State License#:20633527 <br /> OWNER <br /> ETAL,JOHN KOZAR <br /> 2750 KELLY AVE <br /> EXCELSIOR,MN 55331 <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he 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 sepazate <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 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 commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any tjm or due cau e. <br /> ! <br /> ' -� // �/ / a / / <br /> A plicant Permitee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />