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CITY OF ORONO * 2 0 1 2 - 0 0 4 5 0 * <br /> � <br /> '' 2750 KELLEY PARKWAY DATE ISSUED: 05/23/2012 <br /> ' ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4041 NORTH SHORE DR <br /> PIN : 07-117-23-44-0077 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1420 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 6,134.00 <br /> N01`E: REPLACE 2 DOORS WITHIN EXISTING OPENII�TGS <br /> APPLICANT pERMIT FEE SCHEDULE 147.50 <br /> RENEWAL BY ANDERSON STATE SURCHARGE(VALUATIOl� 3.07 <br /> 1920 COLJNTY RD C.WEST <br /> ROSEVILLE,MN 55113 1VIISC FEE 0.00 <br /> (612)502-4777 MAIL-IN FEE 2.00 <br /> Minnesota State License#:BC130983 TOTAL 152.57 <br /> PAID WITH CC# 8788 <br /> OWNER <br /> MCCURDY,DALE <br /> 4041 NORTH SHORE DR <br /> MOUND,MN 55364 <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 sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whett►er or not specified herein.This permit wiil <br /> expire and bewme null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if consiruction is <br /> suspended for a period of 180 days at any time after work has commenced <br /> 'fhe applicant is responsible for assuring all required inspecdons aze <br /> requested in conformance with the State Building Code.This perrnit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued y Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTI�R T DESCRIBED ABO . <br />