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� CITY OF ORO O * z 0 1 4 - 0 0 0 0 9 * <br /> 2750 KELLEY PAR WAY DATE ISSUED: O1/06/2014 <br /> ORONO, MN 553 6- <br /> (952) 249-4600 FAX: (95 ) 249-4616 <br /> ADDRESS : 4135 BAYSIDE RD <br /> PIN : 06-117-23-14-0025 <br /> LEGAL DESC : BAYSIDE RIDGE <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE , <br /> VALUATION : $ 5,500.00 I <br /> NOTE: LENNOX HEATING SYSTEMS-NATURAL GAS <br /> APPLICANT MECHANI AL 68.75 <br /> STATE SU CHARGE MECH(VALUATION) 2.75 <br /> KLEVE&JC MECHANICAL LLC MAIL-IN E 2.00 <br /> 12907 PIONEER TR <br /> EDEN PRAIRIE, MN 55347- TOTAL 73.50 <br /> Payment(s <br /> CREDIT C RD 7744 73.50 <br /> OWIYER <br /> HAYSEEN, CHARLES& HELEN <br /> 4135 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work Yor 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[he work described and does <br /> not grant permission for additional or related work which requires separate <br /> permi[s. All provisions of laws and ordinances governing 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 fbr 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 /> � . / �' / / � / / <br /> Applicant Permitee Signature ate Issue y Signature Date <br /> i I <br />