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CITY OF ORONO I 11111 1 1 1 1MM <br /> * 20 1 S - 0 1 3S8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/27/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1145 WILLOW DR S <br /> PIN : 10-117-23-24-0018 <br /> LEGAL DESC : UNPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : 0/S BUILDING-UNDEFINED <br /> VALUATION : $ 6,680.00 <br /> NOTE: 13 WINDOWS REPLACED <br /> APPLICANT PERMIT FEE SCHEDULE 154.89 <br /> STATE SURCHARGE(VALUATION) 3.34 <br /> PELLA NORTHLAND MAIL-IN FEE 2.00 <br /> 15300 25TH AVE N.- SUITE# 100 <br /> PLYMOUTH,MN 55447- TOTAL 160.23 <br /> (952)345-6047 Payment(s) <br /> Minnesota State License#:BUIL-BC645090 CHECK 72795 160.23 <br /> OWNER <br /> PERL, BETTE <br /> 1145 WILLOW DR S <br /> WAYZATA,MN 55391 <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 /> revoked at any time for due cause. (C) <br /> ( 2Q <br /> e— /o / -27//S <br /> Applicant Permitee Signature Date Issued By nature Date <br />