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�. - . CITY OF ORONO PERMIT NO.: 2009-00523 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: O8/25/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1115 COX FARM RD <br /> PIN : 27-118-23-32-0016 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOF[NG-ASPHALT <br /> VALUATION : $ 11,000.00 <br /> APPLICANT PERMIT FEE SCHEDULE 206.50 <br /> BRAD'S ROOFING LLC STATE SURCHARGE(VALUATION) 5.50 <br /> 12310 CROWN HILL CT <br /> BURNSVILLE, MN 55337- MISC FEE 0.00 <br /> (612)839-7533 TOTAL 212.00 <br /> Minnesota State License#: 20634042 <br /> OWNER <br /> KOSTIAL, BRADFORD& SARAH <br /> 1]15 COX FARM RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifica[ions,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 goveming this type of work <br /> shall be compied with whether or no[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 l80 days a[any time after work has commenced. <br /> The applicant is responsible r assuring all required inspections are <br /> request n co formance h[he State Building Code.This permit may be <br /> revo d [an e for cause. <br /> / / / / <br /> A plicant it ignature Date Issued By Si ture Da - <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCR[BED AB <br />