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CITY OF ORONO PERMIT NO.: 2009-00494 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 08/17/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 581 NORTH STREAM RD <br /> PIN : 25-118-23-34-0005 <br /> LEGAL DESC : NORTH STREAM <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-CEDAR <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 93,713.00 <br /> 6 <br /> APPLICANT PERMIT FEE SCHEDULE 1,011.75 <br /> J BENSON CONSTRUCTION STATE SURCHARGE(VALUATION) 46.86 <br /> 3230 GORHAM AVE <br /> ST LOUIS PARK,MN 55416- TOTAL 1,058.61 <br /> (612)920-0717 <br /> Minnesota State License#:4740 <br /> OWNER <br /> LARSON,DAVID&JANIS <br /> 581 NORTH STREAM 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 /> 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 /> revo d at anytime f�dune cause. Q _ 7 <br /> Y/--r i17i09 �Q <br /> Applicant Ifermitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />