HomeMy WebLinkAbout2010-00764 - roofing .. �
` CITY OF ORONO PERMIT NO.: 2010-00764
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 08/26/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1600 LONG LAKE BLVD
PIN : 26-118-23-33-0032
LEGAL DESC : ALBEES LONG LAKE ADDN
: LOT 001 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S��j��— ��h�
VALUATION : $ 9,899.00
NOTE: TEAR OFF REROOF-SHINGLES
APPLICANT pERMIT FEE SCHEDULE 191.75
KAUFMAN S/M&ROOFING STATE SURCHARGE(VALUATION) 5.00
2521-24TH AVENUE SW
MINNEAPOLIS,MN 5540Cr TOTAL 196.75
(612)722-0965 PAID WITH CC# 8653
Minnesota State License#: 9324
1
OWNER
CAJACOB,CAROL
1600 LONG LAKE BLVD
LONG LAKE,MN 55356
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and speci£cations,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due use.
( �Vl_.cc,c-+-eC� � $i �i�i /O �i2.� i /U
Applicant Permitee Signature Date I ss u By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Fax sent by : 6127221921 KAUFnAN ROOFING 98-23-1e 22:52 Pg: 1/2
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City of Orono �
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
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