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CITY OF ORONO PERMIT NO.: 2009-00571 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/09/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 2185 WATERTOWN RD <br /> PIN 03-117-23-21-0004 <br /> LEGAL DESC UNPLATTED 03 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE MINOR ALTERATIONS <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE ROOFING-ASPHALT <br /> ACTIVITY O/S BUILDING-UNDEFINED <br /> VALUATION $ 17,480.00 <br /> APPLICANT PERMIT FEE SCHEDULE 309.75 <br /> JOHN HOLM CONSTRUCTION STATE SURCHARGE(VALUATION) 8.74 <br /> P.O.BOX 2182 MISC FEE 0.00 <br /> MAPLE GROVE,MN 55311 <br /> (612)799-3390 TOTAL 318.49 <br /> Minnesota State License#: 9283 <br /> OWNER <br /> OTTO,HEINZ <br /> 2185 WATERTOWN RD <br /> LONG LAKE,MN 55356 <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 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 all required inspections are <br /> requested' onf, nce with the Pt*e Building Code.This permit may be <br /> revok at any 'me f!�Z� <br /> / � / <br /> App i7 <br /> t 'tee Signa re Date Issued By Si re Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />