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� CITY OF ORONO PERM[T NO.: 2011-00356 <br /> r � '� 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 05/18/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 793 BOULDER DR <br /> PIN : 33-118-23-i1-0013 <br /> LEGAL DESC : STONEBAY <br /> : LOT O10 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"1'E: TEAR OFF RGROO� <br /> APPLICANT PERMIT FEE SCHEDULE 162.25 <br /> MIDWEST ROOF[NG <br /> 6541 SYCAMORE CT N STATE SURCHARGE(VALUAT[ON) 4.00 <br /> MAPLE GROVE, MN 55369- TOTAL 166.25 <br /> (763)427-9696 <br /> Mi�mesota State License#: 20637010 <br /> OWNER <br /> JODAN, LINDA& ROBERT <br /> 793 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 specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> � shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> �commenced within l80 days of the date oY'issuance,or if construction is <br /> suspended lor a period of 180 days at any time atter work has conunenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State I3uilding Code."l his pennit may bc <br /> revoked at ny 'me for due cause. <br /> .�. � l l�i �� Gf�� J l /�l / <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERM(TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />