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i , <br /> CITY OF ORONO PERMIT NO.: 2009-00282 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/04/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 945 COX FARM RD <br /> PIN : 27-118-23-33-0015 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING -ASPHALT <br /> ACTIVITY : O/S BUILDING -UNDEFINED <br /> VALUATION : $ 48,516.00 <br /> NOTE: <br /> THIS PERMIT INCLUDES RESIDING AND TEAR OFF REROOF <br /> APPLICANT PERMIT FEE SCHEDULE 671.00 <br /> HOME VALUE IMPROVEMENTS STATE SURCHARGE(VALUAT[ON) 24.26 <br /> 18330 GLADSTONE BLVD TOTAL 695.26 <br /> MAPLE GROVE,MN 55311- <br /> (763)425-9500 <br /> Minnesota State License#: 20464927 <br /> OWNER <br /> SANFORD, MATTHEW <br /> 945 COX FARM 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 specitications,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 I 80 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 Sta[e Building Code.This permit may be <br /> revok at a y time fo due ause. <br /> � / � / ���4 <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />