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iiiiiiiiiiiiiimiiiiiiillillillilI <br /> CITY OF ORONO * 2 0 1 3 - 0 1 1 6 8 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/01/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS 1160 WILLOW DR N <br /> PIN 27-118-23-32-0004 <br /> LEGAL DESC UNPLATTED 27 118 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE MINOR ALTERATIONS <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE DOORS <br /> ACTIVITY O/S BUILDING-UNDEFINED <br /> VALUATION ; $ 1,021.00 <br /> NOTE: REPLACE(1)ENTRY DOOR. <br /> APPLICANT PERMIT FEE SCHEDULE 44.50 <br /> DENNIS SARELL CONSTRUCTION INC STATE SURCHARGE(VALUATION) 0.51 <br /> 11368 RED FOX DRIVE TOTAL 45.01 <br /> MAPLE GROVE,MN 55369- <br /> (612)723-2354 <br /> Minnesota State License#: IR665951 <br /> OWNER <br /> HILLSTROM,CLIFFORD <br /> 1160 WILLOW DR N <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'ff <br /> nce with the State Building Code.This permit maybe <br /> revoked tr due ise. <br /> Applicant Permitee Signature Date lssuVfi By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />