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' ' CITY OF ORONO PERMIT NO.: 2011-01564 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEn: 12/19/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1635 CONCORDIA ST <br /> PIN : 17-117-23-22-0040 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1628 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 2,800.00 <br /> NO'1'E: (1)REZNOR UDAP-75-NATURAL GAS <br /> APPLICANT MECHANICAL 50.00 <br /> TOTAL COMFORT STATE SURCHARGE MECH (VALUATION) 1.40 <br /> 4000 W[NNETKA AVE N <br /> SUITE 10 MAIL-IN FEE 2.00 <br /> NEW HOPE, MN 55427- TOTAL 53.40 <br /> 0 PA1D WITH CC# 3913 <br /> OWNER <br /> ALTON, LISA <br /> 1635 CONCORDIA ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according[o <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 /> shail be compied with whether or not specitied 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 t e State Building Code.This permit may be <br /> revok�d at any time for due ca <br /> � �i /�'� // - /�-/ � // <br /> Applicant ermitee Sig Date Issu y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />