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� CITY OF ORONO * Z 0 1 3 - 0 0 3 9 4 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 05/2U2013 <br /> ` ORONO, MN 55356- <br /> • (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3515 SIXTH AVE N <br /> PIN : 29-118-23-43-0002 <br /> LEGAL DESC : UNPLATTED 29 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTTON TYPE : COOLING SYSTEMS <br /> VALUATION : $ 3,500.00 <br /> NOTE: AC UNIT <br /> APPLICANT MECHANICAL 50.00 <br /> COUNTRYSIDE HEATING&COOLING STATE SURCHARGE MECH(VALUATION) 1.75 <br /> 6511 HWY 12 TOTAL 51.75 <br /> MAPLE PLAIN,MN 55359 <br /> (763)479-1600 PAID WITH CC# 7332 <br /> OWNER <br /> WOJCIESZAK,JOY <br /> 3515 SIXTH AVE N <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit 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 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 construction authorized is not <br /> commenced within 180 days of the date of issuance,or if wnstruction 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 permit may be <br /> revoked at any time for due cause. <br /> "1 V�`Nli(V � � / / <br /> Applican Permitee Signature Date Issued y nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />