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CITY OF ORONO * 2 0 1 4 - PJ 1 � 0 5 * <br /> /�� + 2750 KELLEY PARKWAY DATE ISSUED: 09/08/2014 <br /> ORONO, MN 55356- <br /> , (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 890 FOREST ARMS LA <br /> PIN : 07-117-23-12-0007 <br /> LEGAL DESC : FOREST ARMS <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING- UNDEFINED <br /> VALUATION : $ 29,160.00 <br /> NOTE: REPLACE(12)WINDOWS [NTO EXISTING OPEN[NGS. <br /> APPLICANT PERMIT FEF SCHEDULE 466.75 <br /> STATE SURCHARGE(VALUATION) 14.58 <br /> THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00 <br /> 2690 CUMBERLAND PKWY, STE 300 <br /> 30339- TOTAL 483.33 <br /> (763) 542-8826 Payment(s) <br /> Minnesota State License#: BUIL-20268257 CHECK 69091 483.33 <br /> OWNGR <br /> CLARK, MR. R. MRS. <br /> 890 FOREST ARMS LA <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMEIYT <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 additiona]or related work which requires separate <br /> permits. All provisions of laws and ordinances govemin�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 aufhorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of I 80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Ruilding Code.This permit may be <br /> revoked at any time for due cause. <br /> ��• t'w`, /� � r� <br /> Applicant Permitee Signature Date Issued B Signature Date <br />