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{ CITY OF ORONO * Z 0 1 6 - 0 0 9 3 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/10/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 580 NORTH ARM DR <br /> PIN : 06-117-23-42-0005 <br /> LEGAL DESC : VICTORIA ESTATES <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIv TYPE : WINDOWS <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 18,981.00 <br /> NOTE: WINDOW REPLACEMENT <br /> APPLICANT PERMIT FEE SCHEDULE 340.73 <br /> STATE SURCHARGE(VALUATION) 9.49 <br /> PELLA NORTHLAND MAIL-IN FEE 2.00 <br /> 15300 25TH AVE N. -SUITE# 100 <br /> PLYMOUTH, MN 55447- TOTAL 352.22 <br /> (952)345-6047 Payment(s) <br /> Minnesota State License#: BUIL-BC645090 CHECK 75439 352.22 <br /> OWNER <br /> JOHNSON,BRYCE&PAULA <br /> 580 NORTH ARM DR <br /> MOLJND,MN 55364- <br /> AGREEMENT AND SWORIY 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 /> 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 /> revoked at any time for due cause. <br /> � r'����� %t' -�d �� l /v l ! �o <br /> Applicant Permitee Signature Date Issue y ignature Date <br />