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� 4 <br /> CITY OF ORONO PERMIT NO.: 2011-00355 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISS[1ED: OS/18/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 791 BOULDER DR <br /> PIN : 33-118-2�-11-0012 <br /> LEGAL DESC : STONEBAY <br /> : LOT 009 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 8,000.00 <br /> NO�'E: TEAR OFF REROOF <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 162.25 <br /> M[DWEST ROOFING STATE SURCHARGE(VALUATION) 4.00 <br /> 6541 SYCAMORE CT N <br /> MAPLE GROVE, MN 55369- TOTAL 166.25 <br /> (763)427-9696 <br /> Minnesota State License#: 20637010 <br /> OWNER <br /> SCHWARTZMAN,JON&JANE <br /> 425 OXFORD RD <br /> LONG LAKE, MN 55356- <br /> AGREEMEIYT AND SWORN STATEMENT <br /> Tl�e work for which this permit is issucd shall be perfonned according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State E3uilding Code. This permit is I'or only the work described and does <br /> not grant permission�or additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be eompied with whether or i�ot specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of thc date of issuance,or if construction is <br /> suspended for a period of l80 days at any time atter work has conunenced. <br /> The applicant is responsible for assuring all required inspcctions are <br /> reques[ed in conformance with the State Building Code."1'his permit may be <br /> revoked any time for due cause. <br /> _ � 1 �� �� � / <br /> Ap icant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />