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CITY OF ORONO PERMIT NO.: 2009-00595 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 09/16/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1473 BAY RIDGE RD <br /> PIN : 10-117-23-34-0005 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0192 <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 : $ 13,865.35 <br /> NOTE: TEAR OFF-REROOF <br /> APPLICANT pERMIT FEE SCHEDULE 250J5 <br /> GRUSSING ROOFING STATE SURCHARGE(VALUATION) 6.93 <br /> 4305 SHADY OAK RD <br /> HOPKINS, MN 55343 TOTAL 257.68 <br /> Minnesota State License#: 9212 <br /> OWNER <br /> MCCUNE, THOMAS <br /> 1473 BAY RIDGE RD <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 specitications,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[his 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. <br /> ,��"�-�� � / / �jl /�oi O <br /> Ap ip cant Perm�tee Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK HER THAN DESCRIBED ABOVE. <br />