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. <br /> � CITY OF ORONO PERMIT NO.: 2009-00453 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISS[1En: 08/18/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1090 COX FARM RD <br /> PIN : 27-118-23-31-0022 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : DOORS <br /> ACTIVITY : O/S BUILDING-UNDEFWED <br /> VALUATION : $ 5,048.00 <br /> NOTE: REPLACE TWO(2)PATIO DOORS INTO EXISTING OPENINGS. <br /> APPLICANT PERMIT FEE SCHEDULE 132.75 <br /> MINNESOTA RUSCO, INC. STATE SURCHARGE(VALUATION) 2.52 <br /> 5558 SMETNA DRIVE <br /> MINNETONKA, MN 55343- MAIL-IN FEE 2.00 <br /> (952)935-9669 TOTAL 137.27 <br /> Minnesota State License#: 2173 <br /> OWNER <br /> EVERSON,LANCE& KRISTI <br /> 1090 COX FARM RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT A1vD SWORN STATEMENT <br /> The work for which 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 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[he State Building Code.This permit may be <br /> revoked at any[ime for due cadse. <br /> ��'K-Q-�-Q �- / / / / <br /> Applicant Permitee Signature Date Issued Signature e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />