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CITY OF ORONO PERMIT NO.: 2009-00220 <br /> � 2750 KELLEY PARKWAY <br /> ' • ORONO, MN 55356- �ATE IssuEn: OS/14/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4109 HIGHWOOD RD <br /> PIN : 07-117-23-44-0015 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SIDING <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 6,624.00 <br /> NOTF,: RESIDING <br /> APPLICANT PERMIT FEE SCHEDULE 147.50 <br /> THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 3.31 <br /> 3200 COBB GALLERIA PKWY <br /> SUITE 200 MA[L-IN FEE 2.00 <br /> GA 30339- TOTAL 152.81 <br /> (763)542-8826 <br /> Minnesota State License#: 20268257 <br /> OWNER <br /> APPLEBAUM, G&J <br /> 4109 HIGHWOOD RD <br /> MOUND, MN 55364 <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 Buiiding 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. AII provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or no[specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the date of issuance,or if construction is <br /> suspended for a period ot�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 State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �C. / / ������� / / <br /> Applicant Permitee Signature Date Issued By S� nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. <br />