Laserfiche WebLink
CITY OF ORONO PERMIT NO.: 2011-00566 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEn: 07/OU2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4195 FOREST LAKE DR <br /> PIN : 07-117-23-11-0005 <br /> LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN <br /> : LOT 006 BLOCK 003 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCT[ON TYPE : ROOF[NG-ASPHALT <br /> ACT[VITY : O/S BUILDING- UNDEFINED <br /> VALUATION : $ 7,200.00 <br /> NOTE: IF AN ON-SITE INSPECTION IS NOT DONE WITH A 1'F;AR-OFF,MAKE SURF,TO LEAVE PICTURF,S ON-SITE IN BAG W/ <br /> ORGANCE INSPECTION CARD. <br /> SIGNS ADVERTISING WORK-CAN ONLY BE PLACED ON FRONT LAWN DURING THE"I'IME THE ROOF IS I3E[NG DONE, MUST C3E <br /> REMOVED AFTER JOB IS DONE. <br /> APPLICANT pERMIT FEE SCHEDULE 16225 <br /> JENSEN CONSTRUCTION SERVICES LLC STATE SURCHARGE(VALUATION) 3.60 <br /> 2620 GRANGER LN <br /> MOUND, MN 55364- TOTAL 165.85 <br /> (952)472-7223 PAID WITH CC# 3589 <br /> Minnesota State License#: 20639601 <br /> OWNER <br /> BLOMS, GERALD&NANCY <br /> 4195 FOREST LAKE DR <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 responsibic tor assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be � � �� <br /> revoked at y time for due cause. //f <br /> .^ _ , �� l-� <br /> �� � � <br /> Appl�cant Permitee Signature Date Issued By Signa ure DaCe <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />