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CITY OF ORONO PERMIT NO.: 2011-00533 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISsuEn: 06/28/2011 <br /> � ` 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3680 JACOBS MILL RD <br /> PIN : 32-118-23-24-0009 <br /> LEGAL DESC : JACOBS MILLS <br /> � : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MINOR ALTERATIONS <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ROOFING-ASPHALT <br /> ACTIVITY : O/S BUILDING-UNDEFINED <br /> VALUATION : $ 13,420.00 <br /> APPLICANT pERMIT FEE SCHEDULE 250.75 <br /> DAN LILLESTOL ABLE RESTORATION STATE SURCHARGE(VALUATION) 6.71 <br /> 17316 KENYON AVE#103 TOTAL 25'7.46 <br /> LAKEVILLE,MN 55044 <br /> (612)280-4807 <br /> OWNER <br /> COLLINS, STEVEN&BARBARA <br /> 3680 JACOBS MILL 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 specifications,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 sepazate <br /> pertnits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not speci5ed 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 construction is � J � <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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> i l �i��'i /� <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />