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� � <br /> CITY OF ORONO * Z 0 1 4 - 0 1 3 2 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: lUi7/2014 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 2503 KELLY AVE <br /> PIN : 20-117-23-12-0054 <br /> LEGAL DESC : KELLY COVE <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : ADDITION/REMODEL/REPAIR <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR <br /> ACTIVITY : 434-RESIDENTIAL <br /> VALUATION : $ 10,000.00 <br /> NOTE: WINDOW REPLACEMENT <br /> APPLICANT PERMIT FEE SCHEDULE 191.75 <br /> PLAN REVIEW 124.64 <br /> NEIGHBORHOOD BLDG STATE SURCHARGE(VALUATION) 5.00 <br /> 10024 MINNETONKA BLVD <br /> MINNETONKA, MN 55305- TOTAL 321.39 <br /> (612)840-1703 Payment(s) <br /> Minnesota State License#: BUIL-BC003096 CHECK 21299 321.39 <br /> OWNER <br /> REVOR,MARGENE <br /> 2503 KELLY AVE <br /> EXCELSIOR,MN 55331- <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 sepazate <br /> permits. All provisions of laws and ordinances governing 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 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 in conformance with the State Building Code.This permit may be <br /> revoke�l�t-S time for due cause. <br />� //l /7 �/ 5� <br /> Applicant Permitee Signature Date Issu By Signature Date <br />