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CITY OF ORONO PERMIT NO.: 2011-00543 <br /> 2750 KELLE�' PARKWAY <br /> ' � ORONO, MN 55356- �ATE ISSUE�: 06/28/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1082 LOMA LINDA AVE <br /> PIN : 08-117-23-23-0009 <br /> LEGAL DESC : LOMA LINDA <br /> : LOT 008 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTNITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 6,500.00 <br /> APPLICANT PERMIT FEE SCHEDULE 147.50 <br /> J ZAC, INC. <br /> 5249 OGREN AVE NE STATE SURCHARGE(VALUATION) 3.25 <br /> MN 55376- MISC FEE 0.00 <br /> (763)497-4444 TOTAL 150.75 <br /> Minnesota State License#: 20593845 PAID WITH CC# 8377 <br /> OWNER <br /> TOMAN,JULIE <br /> 1082 LOMA LINDA AVE <br /> MOLJND, MN 55364 <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 rela[ed 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 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 n conformance with the State Building Code.This permit may be <br /> revoked t ny time for due-�ause. _ <br /> l/ <br /> � / / / / <br /> Appli ant er rt ig ture Date Issue y 'g ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCWBED ABO <br />