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� CITY OF ORONO *�6 - 0 0 4 9 9 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: OS/10/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1650 SHADYWOOD RD <br /> PIN : 17-117-23-21-0014 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DOORS <br /> ACTNITY : O/S BUILDING-LJNDEFINED <br /> VALUATION : $ 3,870.00 <br /> NOTE: REPLACE(1)PATIO DOOR WITHIN EXISTING OPENING <br /> APPLICANT PERMIT FEE SCHEDULE 108.38 <br /> RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 1.94 <br /> 1920 COUNTY RD C. WEST MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 112.32 <br /> (612)502-4777 Payment(s) <br /> Minnesota State License#: BUIL-BC130983 CREDIT CARD 8788 112.32 <br /> OWNER <br /> KREISLER,JERROLD&BARBARA <br /> 1650 SHADYWOOD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permi[is issued shall be performed according to <br /> the approved plans and specifica[ions,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 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 aIl required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. - <br /> i <br /> /� /� <br /> L�.��� � d J i�� i�� <br /> Applicant Permitee Signature Date sue y Signature Date <br /> � <br />