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CITY OF ORONO * 2 0 1 3 - 0 0 7 2 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/OS/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2700 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0012 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPF, : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 10,920.00 <br /> NO�I�E: WINDOW RF,PLACF.MEN"I'& SI'UCCO RI�:PAIRS <br /> APPLICANT PERM[T FEE SCHEDULE 206.50 <br /> HUNERBERG CONSTRUCTION CO STATE SURCHARGE(VALUATION) 5.46 <br /> 1 1 102 86TH AVE N <br /> MAPLE GROVE, MN 5531 1- MAIL-IN FEE 2.00 <br /> (763)463-5040 TOTAL 213.96 <br /> Minnesota State License#: 3243 PAID WITH CC# 9238 <br /> OWNER <br /> BAIRD, MICHAEL&APRIL <br /> 2700 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be perlbm�ed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. �This pemiit is for only the work described and does <br /> not erant permission for additional or related work which requires separate <br /> pemiits. nll provisions of laws and ordinances governing this type of worl: <br /> shall be compied with whether or not specitied herein.This permit�vill <br /> expire and become null and void if construction authorircd 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 inspcctions are <br /> requested in conformance with the State Building Code.'I�his permit may be <br /> revoked at any time for due cause. <br /> S'� �- � /3 � � <br /> Applicant crmitce Signaturc Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />