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, CITY OF ORONO * Z 0 1 5 - 0 1 3 4 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/16/2015 <br /> ORONO, MN 55356- <br /> 952) 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 4565 BAYSIDE RD <br /> PIN : 06-117-23-21-0010 <br /> LEGAL DESC : BAYSIDE BERRY FARM <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 35,000.00 <br /> NOTE: 3 HEATING SYSTEMS(2 LENNOX& 1 TRIANGLE TUBE),2 COOLING SYSTEMS(LENNOX), 1 KITCHEN EXHAUST,9 BATH <br /> EXHAUSTS <br /> APPLICANT MECHANICAL 437.50 <br /> STATE SURCHARGE MECH(VALUATION) 17.50 <br /> MASSMANN,GEOTHERMAL&MECH MAIL-IN FEE 2.00 <br /> 27944 96TH STREET <br /> ZIMMERMAN,MN 55398 TOTAL 457.00 <br /> (763)416-5066 Payment(s) <br /> Minnesota State License#: mech-MB003981 CHECK 4446 457.00 <br /> OWNER <br /> DOUBECK,TIM&MARY <br /> 4565 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 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[he 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 /'�%j/) <br /> revoked at any time for due cause. . �(��/ <br /> � �`'�_c�k� � ,� �?C '� l�E,�`f�Z� f�,, i � --- <br /> � <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> I � I <br />