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^ CITY OF ORONO <br /> * Z P1 1 2 - P1 1 0 9 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/30/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2515 KELLY AVE <br /> PIN : 20-117-23-12-0038 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1428 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-OTHER <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 113,000.00 <br /> NOTE: TEAR OFF TILE ROOF AND REPLACE WITH DAVINCI BELLAFORTE SLATE <br /> APPLICANT pERMIT FEE SCHEDULE 1,134.75 <br /> 1-DERFUL ROOFING&RESTORATION STATE SURCHARGE(VALUATION) 56.50 <br /> 2973 S NOVA ROAD <br /> 80470- TOTAL 1,191.25 <br /> (303)984-7663 PAID WITH CC# 2911 <br /> Minnesota State License#:BC639819 <br /> OWNER <br /> HARDTEN,DAVID&CHRISTINE <br /> 2515 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 Ciry 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 /> 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 witi�in 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time aRer work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �� � �i �i � / � � <br /> Applicant Permitee Signature Date ssued y Signature �Dat� / / <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />