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CITY OF ORONO *�� 0 1 0 5 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/09/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3460 BIRCH LA <br /> PIN : 08-117-23-43-0027 <br /> LEGAL DESC : LYDIARDS PARK LAKE MTKA <br /> : LOT 019 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 8,000.00 <br /> NOTF,: NATURAL GAS BOILER <br /> APPLICANT MECHANICAL ]00.00 <br /> COUNTRYSIDE HEATING & COOLING <br /> 651 1 HWY 12 STATE SURCHARGE MECH (VALUATION) 4.00 <br /> MAPLE PLAIN, MN 55359 MAIL-IN FEE 2.00 <br /> (763)479-1600 TOTAL 106.00 <br /> PAID WITH CC# 9617 <br /> OWNER <br /> LISLE, STEVE&ANGELA <br /> 3460 BIRCH LA <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIVD SWORN STATEMENT <br /> I'he work fbr which this permit is issued shall be perfbnned according to <br /> the approved plans and spccitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> no[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 the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time afrer 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 /> � � ��;� ��y`�--,;�-- i�, �, , /-� <br /> Applicant Permitee Signature Date <br /> ��s�ue By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />