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� •� CITY OF ORONO PERMIT NO.: 2011-00278 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �A7'E issuEu: OS/03/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 782 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0023 <br /> LEGAL DESC : STONEBAY FOURTH ADDITION <br /> : LOT 012 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING - UNDEFINED <br /> VALUATION : � 8,000.00 <br /> No�rr: rr-,��z orr a�Roor <br /> APPLICANT <br /> PERMIT FEE SCHEDULE 162.25 <br /> MIDWEST ROOFING STATE SURCHARGE(VALUATION) 4.00 <br /> 6541 SYCAMORE CT N <br /> MAPLE GROVE, MN 55369- TOTAL 166.25 <br /> (763)427-9696 <br /> Minnesota State License#: 20637010 <br /> OWNER <br /> LURTON, H WILLIAM <br /> PO BOX 408 <br /> LONG LAKE, MN 55356-0408 <br /> AGREEMENT AND SWORN STATEMENT <br /> "Che work for which this permit is issued shall be performed according to <br /> thc approved plans and specifications,applicable City approvals,and thc <br /> State I3uilding Code. 7'his permit is for only the work described and does <br /> not grant permission for additional or related work which rcquires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall bc compied with whether or not specified herein.This permit will <br /> expire and bccome null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspcnded for a period of I 80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requcsted in conformance wiUi the State Buildine Code.This permit may be <br /> revoked at any ime f r due cause. <br /> S� 3 � 11 ��''l�l�� �,� , / <br /> Ap icant Pennitee Signaturc Date Issu I3y Signaturc Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />