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� CITY OF ORONO PERMIT NO.: 2009-00310 <br /> 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUED: 06/1U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2735 COLTNTRYSIDE DR W <br /> PIN : 04-117-23-12-0018 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 003 BLOCK 003 <br /> PERM[T TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,264.00 <br /> NOTE: 1 BRYANT NATURAL GAS FURNACE <br /> APPLICANT <br /> MECHAN[CAL 53.30 <br /> STANDARD HEATING &AIR CONDITIONING STATE SURCHARGE MECH (VALUATION) 2.13 <br /> 410 WEST LAKE STREET <br /> MINNEAPOLIS, MN 55408-2998 MA[L-IN FEE 2.00 <br /> 612-8242656 TOTAL 57.43 <br /> OWNER <br /> ALEXANDER, TIM <br /> 2735 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work Yor which this permit is issued shall be performed according[o <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 specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the date of issuance,or if consVuction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring alI required inspections are <br /> requested in conformance with the State Building Code.This permi[may be <br /> revoked at any time for due cause. <br /> � <br /> ���'GQ'c'� �. l l l l <br /> Applicant Permitee Signature Date Issued By S' ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />