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. ' CITY OF ORONO * z 0 1 5 - 0 1 1 7 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/14/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4105 BAYSIDE RD <br /> PIN : 06-117-23-14-0023 <br /> LEGAL DESC : BAYSIDE RIDGE <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�I TYPE : VENTILATION <br /> VALUATION : $ 1,225.00 <br /> NOTE: REPLACE 1 -6"KITCHEN EXHAUST <br /> GAS LINE ONLY FOR RANGE(RELOCATE AND HOOKUP) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.61 <br /> PATTON HEAT[NG&AIR CONDITIONING MAIL-IN FEE 2.00 <br /> 589 SWAN LAKE LANE NW <br /> TOTAL 52.61 <br /> CEDAR, MN 55011- <br /> (763)444-8567 Payment(s) <br /> CHECK 4906 52.61 <br /> OWNER <br /> BURKE,NICK&SUE <br /> 4105 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <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 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 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 State Building Code.This permit may be <br /> revoked at any time for due cause. �)�„ <br /> �a� <br /> �I�-� C �-�� b � 1��.�� ��: � � � � is <br /> Applicant Permitee Signature Date Issued y Sign re Date <br />