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CITY OF ORONO PERM[T NO.: 2010-00962 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuE�: 10/07/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 755 DICKEY LAKE DR <br /> P I N : 34-118-23-22-0009 <br /> LEGAL DESC : RINGERSWOOD <br /> : LOT 005 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ROOF[NG -ASPHALT <br /> ACTIVITY : O/S BUILDING- LJNDEFINED <br /> VALUATION : $ 7,200.00 <br /> APPLICANT PERMIT FEE SCHEDULE 162.25 <br /> MIDWEST ROOF[NG STATE SURCHARGE(VALUATION) 5.00 <br /> 6541 SYCAMORE CT N <br /> MAPLE GROVE, MN 55369- MISC FEE 0.00 <br /> (763)427-9696 TOTAL 167.25 <br /> Minnesota State License#: 20637010 <br /> OWNER <br /> ESAU, TERRANCE& MARY <br /> 755 D[CKEY LAKE DR <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performcd according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State I3uilding Codc. "I'his permit is for only the work dcscribed and does <br /> not grant permission for additional or rclated work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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�'ate of issuance,or if construction is <br /> suspended�for a pe �od of 180 da�at any time after work has commenced. <br /> The applicant is res�onsible for:assuring all required inspections are <br /> requested in confo�nance with'the State I3uilding Code.This permit may be <br /> revoked at any tinie for due c�lus . <br /> . ��^ �(/� �l l U <br /> / / <br /> icant�e itee Signature Date Issued By �g ature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER AN DESCRIBED ABO - <br />