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s ti CITY OF ORONO PERMIT NO.: 2011-00192 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 04/01/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 845 WILLOW DR S <br /> PIN 10-117-23-22-0002 <br /> LEGAL DESC UNPLATTED 10 117 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 $ 2,000.00 <br /> NOTE: PARTIAL TEAR OFF REROOF <br /> APPLICANT PERMIT FEE SCHEDULE 73.75 <br /> TSCHIDA CONSTRUCTION STATE SURCHARGE(VALUATION) 5.00 <br /> 522 6TH AVE E TOTAL 78.75 <br /> SHAKOPEE,MN 55379- <br /> (952)201-4190 PAID WITH CC# 5109 <br /> Minnesota State License#: 20637142 <br /> OWNER <br /> WILLIAMS,ROBERT&JORDANNA <br /> 845 WILLOW DR S <br /> 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 conform th the State Building Code.This permit may be <br /> revo Ume for cause. <br /> A- / ! / (/ <br /> Applicant Permitee Signature Dae IssBy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK O ER THAN DESCRIBED ABOVE. <br />