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CITY OF ORONO PERMIT NO.: 2011-00324 <br /> � " 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEn: 05/1 U2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 752 BOULDER DR <br /> PIN : 33-118-23-11-0015 <br /> LEGAL DESC : STONEBAY <br /> : LOT 012 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERAT[ONS <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACT[VITY : O/S BUILDtNG - UNDEFINED <br /> VALUATION : $ 8,000.00 <br /> NOTE: '1�EAR OFF REROOF <br /> I <br /> i <br /> APPLICANT 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 /> OWIVER <br /> INDAHL, DENNIS&ELAINE <br /> 752 BOULDER DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pennit 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�rant pennissfon for additional or related work which requires separate <br /> permits. All prov�sions of laws and ordinances goveming 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 constriiction is <br /> suspended lar a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> reques d in confonnance with the State I3uilding Code.This perinit may be <br /> revo� at a time for d ause. <br /> � � �� � � � <br /> Applicant Permitee Signature Date � Issued 13y nature a e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />