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CITY OF ORONO PERMIT NO.: 20o9-oossa <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 09/02/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3770 BAYSIDE RD <br /> P1N : OS-117-23-24-0121 <br /> LEGAL DESC : OTTOVILLE ON LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT D�S �� <br /> VALUATION : $ 16,000.00 <br /> NOTE: REPAIR STORM DAMAGED ROOF <br /> APPLICANT pERMIT FEE SCHEDULE 280.25 <br /> TONKA ROOFING STATE SURCHARGE(VALUATION) 8.00 <br /> 4573 SADDLEWOOD DR. TOTAL 28825 <br /> MINNETONKA, MN 55345- <br /> (612)598-3116 PAID WITH CC# 3309 <br /> Minnesota State License#: 20586668 <br /> OWNER <br /> III, W[NFIELD STEPHENS <br /> 3770 BAYSIDE RD <br /> LONG LAKE, MN 55356- <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 co ormance with the State Building Code.This permit may be <br /> revok i r due cause. <br /> � ___.._ /���Z-/Q ' <br /> / / <br /> pplicant Permitee Signature Date Issued By Si ture e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV <br />