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, ., CITY OF ORONO * Z 0 1 3 - 0 P1 2 0 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/28/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2735 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0018 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 003 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 6,072.00 <br /> NOTE: 1 BRYANT NAT GAS FURNACE <br /> APPLICANT MECHANICAL 75.90 <br /> STANDARD HEATING&AIR CONDITIONING STATE SURCHARGE MECH(VALUATION) 3.04 <br /> 130 PLYMOUTH AVENUE N. <br /> MINNEAPOLIS, MN 5541 1- MAIL-IN FEE 2.00 <br /> 612-824-2656 TOTAL 80.94 <br /> OWNER <br /> ALEXANDER, TIM <br /> 2735 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> [he 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 goveming 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 da�c of issuance,or if construction is <br /> suspended for a period of 180 days af any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State[3uilding Code.This permit may be <br /> revoked at any time for due cause. <br /> �L�L�I � � � l l <br /> Applicant Permitee Signature Date <br /> Issued By ' nature e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />