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* . s <br /> CITY OF ORONO PERMIT NO.: 2011-00294 <br /> . 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE �SSUEn: OS/04/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 753 BOULDER DR <br /> PIN : 33-118-23-11-0074 <br /> LEGAL DESC : STONEBAY THIRD ADDITION <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : M1NOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING- UNDEF[NED <br /> VALUATION : $ 6,000.00 <br /> NO"fE: 1'EAR OP�RGROOF <br /> APPLICANT PERMIT FEE SCHEDULE 132J5 <br /> MIDWEST ROOFING STATE SURCHARGE(VALUATION) 3.00 <br /> 6541 SYCAMORE CT N <br /> MAPLE GROVE, MN 55369- TOTAL 135.75 <br /> (763)427-9696 <br /> Minnesota State License#: 20637010 <br /> OWNER <br /> O.T. Development, LLC <br /> LLC, O.T. DEVELOPMENT, <br /> 2670 KELLEY PKWY <br /> ORONO, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The wark Cor which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> Statc Building Code. This permit is for only the H�ork described and docs <br /> not grant permission for additional or related work which requires separate <br /> � permits. All provisions of la���s and ordinances governing lhis 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[3uilding Code.This permit may be <br /> rcvoked at any time for ue cause. <br /> � �� � �/� / / ! <br /> Applicant Permitee Signature Date Iss By Signature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />