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CITY OF ORONO * z Q� 1 4 - 0 0 4 5 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/19/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3470 BIRCH LA <br /> PIN : 08-117-23-43-0001 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 8,000.00 <br /> NOTE: 1 I3RYANT NAT GAS PURNACG <br /> 1 aRYAN"C 3"I'ON AC <br /> APPLICANT MECHANICAL ]00.00 <br /> STATE SURCHARGE MECH (VALUATION) 4.00 <br /> COUNTRYSIDE HEATING& COOLING MAIL-IN FEE 2.00 <br /> 1960 COUNTY ROAD 90 <br /> SUITE 200 TOTAL 106.00 <br /> MAPLE PLAIN, MN 55359 Payment(s) <br /> (763)479-1600 CREDIT CARD 8071 106.00 <br /> OWNER <br /> BERNARD, MR. & MRS. <br /> 3470 BIRCH LA � <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> 'fhe work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and [hc <br /> State Building Code. This permit is for only the work describcd and does <br /> not grant permission for additional or related work which requires separale <br /> permits. All provisions oY 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 Ihe date of issuance,or if construction is <br /> suspended for a period of 180 days at any[ime after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Quilding Code.This permit may be <br /> revoked at any time for due cause. <br /> �/Z�'(�'c� / / <br /> Applicant Permitee Signature Date Issued By S� ature Date <br />