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CITY OF ORONO PERMIT NO.: 2011-00492 <br /> e 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/20/2011 <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4665 WEST BRANCH RD <br /> PIN : 07-117-23-22-0015 <br /> LEGAL DESC : WEST BRANCH HILL <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : 0/S BUILDING-UNDEFINED <br /> VALUATION : $ 5,000.00 <br /> NOTE: WINDOW REPLACEMENT-SOFFIT AND FASCIA <br /> APPLICANT PERMIT FEE SCHEDULE 118.00 <br /> SMC HANDYMAN SERVICES STATE SURCHARGE(VALUATION) 2.50 <br /> 12995 135 STREET TOTAL 120.50 <br /> NORWOOD YOUNG AMERICA,MN 55368- <br /> (952)688-2800 <br /> Minnesota State License#: 20633103 <br /> OWNER <br /> GROVE,JOHN&CARMEN <br /> 4665 WEST BRANCH RD <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 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 /> revoke. . . due se. <br /> (/ /JO' / 26 1,1 / � 4,/ .2D / <br /> / <br /> /,,r <br /> Applicant Permitee Signature Date Issue By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />