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_ �` CITY OF ORONO PERMIT NO.: 2010-00892 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/24/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2715 COUNTRYSIDE DR W <br /> PIN : 04-ll 7-23-12-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 003 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RES[DENT[AL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING -LINDEFINED <br /> VALUATION : $ 7,514.00 <br /> NOTE: REPLACG(6)WINDOWS AND(2)SASH <br /> APPLICANT PERMIT FEE SCHEDULE � 162.25 <br /> SCHERER WINDOW& DOOR CONSULTANTS STATE SURCHARGE(VALUATION) 5.00 <br /> ]0751 EXCELSIOR BLVD. <br /> HOPKINS, MN 55343 MAIL-[N FEE 2.00 <br /> (952)277-1635 TOTAL 169.25 <br /> Minnesota State License#:.20239369 PAID WITH CC# 3989 <br /> OWNER <br /> WILSON, MARK& KIRSTIN <br /> 2715 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for�rhich 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 pem�it 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 constraction 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 /> reyuested in conformance with the State[3uilding Code.This permit may be <br /> revoke at any time for due c use. <br /> � g� �7�/� �i 4�i /C� <br /> Applicant Permitee Signature Date [ss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />