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CITY OF ORONO PERMIT NO.: 2010-01044 <br /> / ' 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE issuE�: 10/22/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 50 HACKBERRY HILL <br /> PIN : 33-118-23-44-0025 <br /> LEGAL DESC : DANIELS LONG LAKE HEIGHTS <br /> : LOT 006 BLOCK 003 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING- UNDEFINED <br /> VALUATION : $ 9,960.00 <br /> NO"I'E: RL'ROOF-TGAR OPF <br /> APPLICANT pERMIT FEE SCHEDULE 191.75 <br /> EXECUTIVE EXTERIORS& REMODELING STATE SURCHARGE(VALUATION) 5.00 <br /> 4205 LANCASTER LANE <br /> PLYMOUTH, MN 55447- TOTAL 196.75 <br /> (763)432-4677 PA[D WITH CC# 5383 <br /> Minnesota State License#: 20592356 <br /> OWNER <br /> AUTRY, MARY <br /> 50 HACKBERRY HILL <br /> LONG LAKE, MN �5356 <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This pcnnit is tbr only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> pennits. All provisions of laws and ordinances�oveming this type of work <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commcnced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter 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. <br /> �e�z�C��'�r�✓1, i� �Z2 �l� /D, o�a; /�} <br /> Applicant Pcrmitee Signature Date Issu 3y Signature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />