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CITY OF ORO O * 2 0 1 5 — 0 1 1 0 6 * <br /> ' 2750 KELLEY PAR WAY nAT� [ssuEn: 08/3U2015 <br /> � ORONO, MN 55 56- <br /> (952) 249-4600 FAX: (95 ) 249-4616 <br /> ADDRESS : 4165 BAYSIDE RD <br /> PIN : 06-117-23-14-0019 <br /> LEGAL DESC : REG. LAND SURVEY NO.0748 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> COI�ISTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 9,200.00 <br /> NOTE: 2 COOLING SYSTEMS(BRYANT) <br /> APPLICANT MECHAN CAL 115.00 <br /> STATE S RCHARGE MECH (VALUATION) 4.60 <br /> KLEVE&JC MECHANICAL LLC MAIL-IN EE 2.00 <br /> 12907 PIONEER TR <br /> EDEN PRAIRIE, MN 55347- TOTAL 121.60 <br /> Minnesota State License#: mech-658861 Payment( ) <br /> CHECK 12931 121.60 <br /> OWNER <br /> ALT, JAMES&MAR[E <br /> 4165 BAYSIDE RD <br /> MAPLE PLA[N, 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 sepazate <br /> permits. AII 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 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. f / <br /> / 1� <br /> � <br /> ��Gc i C�c-� �.�-� /��,� �f `� (� �' �3� � / <br /> Applicant Permitee Signature Date Issued B Signature Date <br />