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CITY OF ORONO PERMIT NO.: 2010-00027 <br /> " 2750 KELLEY PARKWAY <br /> � � ORONO, MN 55356- �ATE IssuE�: OU2U2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1223 BROWN RD S <br /> PIN : 10-117-23-31-0065 <br /> LEGAL DESC : MAXWELLS ADDN CRYSTAL BAY LAKE <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,000.00 <br /> NOTE: MAKE:PAYNE,MODEL:PG8MAA0361 10,NAT GAS, [NPUT 1 10,000 <br /> APPLICANT MECHANICAL 50.00 <br /> COUNTRYSIDE HEATING&COOLING STATE SURCHARGE MECH(VALUATION) 1.00 <br /> 6511 HWY 12 TOTAL 51.00 <br /> MAPLE PLAIN, MN 55359 <br /> (763)479-1600 <br /> OWNER <br /> QUADY, CURTIS <br /> 1223 BROWN RD S <br /> P.O. BOX 127 <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Building Code. This permit is for only the work described and docs <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whcther or not specified herein.This pennit will <br /> expire and become null and void it�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 /> requestec�in conformance with the State Building Code.This permit may be �� <br /> revoked at any time for due cause. � j _Z j _�� <br /> r ( <br /> l.. .^�� / � I l rr� l�-�l l <br /> App�lic t Permitee Signature Date ' <br /> � � Issued By Signat �e Date <br /> SEPARATE PERMTTS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />