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IINIA I I I I III II II III I 111 1I 11111111 <br /> CITY OF ORONO <br /> * 20 1 2 - 0 1 1 46 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/09/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 850 WAYZATA BLVD W <br /> PIN : 35-118-23-44-0004 <br /> LEGAL DESC : UNPLATTED 35 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : INSTITUTIONAL-SCHOOL <br /> CONSTRUCTION TYPE : ROOFING-OTHER <br /> ACTIVITY : 0/S BUILDING-UNDEFINED <br /> VALUATION : $ 50,758.00 <br /> NOTE: REMOVE AND REPLACE TPO ROOF AND METALS <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 689.25 <br /> SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 25.38 <br /> 12366 RIVER RIDGE ROAD <br /> BURNSVILLE, MN 55337- MAIL-IN FEE 2.00 <br /> (612)861-7000 TOTAL 716.63 <br /> Minnesota State License#: 20593656 PAID WITH CC# 1521 <br /> OWNER <br /> Montessori School <br /> OMS PROPERTIES LLC <br /> 760 HUNT FARM 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 in conformance with the State Building Code.This permit may be <br /> revo at any time for dug cause. <br /> 0411,fr 414A-11-AA- 11/ 9 / 2__ <br /> Applicant Permitee Signature Date IssuekBy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />