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CITY OF ORONO PERMIT NO.: 200&00325 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/23/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2715 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 700.00 <br /> NO"I'E: <br /> 1 KITCHGN EXHAUST <br /> 1 GAS LINE <br /> APPLICANT MECHANICAL 35.00 <br /> KLEVE HEATING&AIR STATE SURCHARGE MECH (VALUATION) 0.50 <br /> 6365 CARLSON DRIVE SUITE G <br /> EDEN PRAIR[E, MN 55346- MAIL-[N FEE 1.50 <br /> (612)941-421 1 TOTAL 37.00 <br /> OWNER <br /> WILSON, MARK& KIRSTIN <br /> 2715 COUNTRYS[DE DR W <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMEIVT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days oY the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> I'he 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�,ause. <br /> �'jl�t.e�.c.� C.tL l l <br /> � � <br /> Applicant Permitee Signature Date Issued By nature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESC ED ABOVE. <br />