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CITY OF ORONO * 2 0 1 6 - 0 1 z� <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/13/2016 <br /> ORONO, MN 55356- <br /> ' (952) 249-4600 FAX: (952) 249-4616 <br /> ADURESS : 2715 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 003 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 2,957.00 <br /> NOTE: REPLACEC 2 WINDOWS IN EX[ST[NG OPENINGS <br /> APPLICANT PERMIT FEE SCHEDULE 92.89 <br /> STATE SURCHARGE(VALUATION) 1.48 <br /> SCHERER BROS LUMBER MAIL-IN FEE 2.00 <br /> 10751 EXCELSIOR BLVD <br /> HOPKINS,MN 55343 TOTAL 96.37 <br /> (952)277-1600 Payment(s) <br /> Minnesota State License#: BUIL-BC239369 CREDIT CARD 3281 96.37 <br /> OWNER <br /> WILSON, MARK& K[RSTIN <br /> 2715 COUNTRYSIDE DR W <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 specifications,applicable City approvals,and the <br /> Sta[e 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 govcrning this type of work <br /> shall be compied with whether or not speci6ed herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the date of issuance,or if construclion 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 the State Building Code.This permit may be <br /> revoked at any time for due cause. I��7 <br /> ����1c� � �� � �-�,�f '�����. �-�--� I'.�� �-t� ��, �%�, ib <br /> Applicant Permitee Signature Date Issued By Signature Date <br />