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r. <br /> � CITY OF ORONO PERMIT NO.: 2009-00630 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 09/28/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1700 SHORELINE DR <br /> PIN : 10-117-23-14-0014 <br /> LEGAL DESC : LJNPLATTED 10 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,845.00 <br /> NOTE: 1 LENNOX NAT.GAS HEATING SYSTEM <br /> PD WITH 2 CHECKS <br /> $38.48#2477 <br /> $14.94#2478 <br /> APPLICANT MECHANICAL 50.00 <br /> SELECT MECHANICAL SERVICES INC. STATE SURCHARGE MECH(VALUATION) 1.42 <br /> 6219 CAMBRIDGE ST <br /> ST.LOUIS PARK,MN 55416- MAIL-IN FEE 2.00 <br /> (952)926-4488 TOTAL 53.42 <br /> PAID WITH CASH 14.94 <br /> OWNER <br /> ETAL,IRWIN JACOBS <br /> 1700 SHORELINE DR <br /> WAYZATA,MN 55391 <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 dces <br /> not grant permission 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 specified herein.This permit will <br /> expire and become null and void if conswction authorized is not <br /> commenced within 180 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 aze <br /> requested in conformance with the State Building Code.This pertnit may be <br /> revoked at an time for due_cause. <br /> �"iI�'�- _ � ` � � l/��..�j(. / / <br /> Applicant Permitee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />