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R- CITY OF ORONO PERMIT NO.: 2009-00317 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUED: 06/15/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 265 HOLLANDER RD <br /> PIN : 25-118-23-43-0016 <br /> LEGAL DESC : HOLLY ACRES <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-CEDAR <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATIOI�1 : $ 42,000.00 <br /> APPLICANT PERMIT FEE SCHEDULE 595.75 <br /> PLYMOUTH ROOF[NG& INSULATION STATE SURCHARGE(VALUATION) 21.00 <br /> 17525 CTY ROAD 24 <br /> PLYMOUTH,MN 55447 TOTAL 616.75 <br /> (763)473-3397 <br /> Minnesota State License#: 5358 <br /> OWNER <br /> DOEPKE, MARK&CONSTANCE <br /> 265 HOLLANDER RD <br /> WAYZATA, MN 55391 <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 /> 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 governing this type of work <br /> shail be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is no[ <br /> commenced within 180 days of the date of issuance,or if construction 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 conformance w t S ata Building Code.This permit may be <br /> � <br /> revo t a e f r d ca e.� ) <br /> � i I�i�C�� i i <br /> Applicant Pe itee ignature Date Issued Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />