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� � • CITY OF ORONO * 2 0 1 4 - PJ 0 7 8 9 * <br /> 2750 KELLEY PARKWAY DATF. ISSUED: 07/25/2014 <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 /> LF.GAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 003 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 4,526.00 <br /> APPLICAIYT MECHANICAL 56.58 <br /> STATE SURCHARGE MECH (VALUATION) 2.26 <br /> STANDARD HEA I[NG& AIR COND[TIONING MAIL-IN FEE 2.00 <br /> 130 PLYMOUTH AVGNUE N. <br /> MWNEAPOLIS, MN 55411- TOTAL 60.84 <br /> 612-824-2656 Payment(s) <br /> CHECK 46768 60.84 <br /> OWNER <br /> ALEXANDF,R, TIM <br /> 2735 COUNTRYSIDE DR W <br /> LONG LAKE, MN 553�6 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed accordin�to <br /> the approved plans and specifications.applicable City approvals,and thc <br /> State f3uilding Code This permit is for only the work described and docs <br /> not grant permission for additional or rclated work which requires separate <br /> permi(s. nll provisions oY laws and ordinanees governing this type of H�ork <br /> shall he compied with whether or not specified herein.This permit will <br /> expire and become null and void if�construction authorized is not <br /> commenced�vithin 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time at�ter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requcsted in conformance with the State l3uildin�Code.This pem�it may hc <br /> rcvoked at any time for due cause. <br /> �_I'��r�.1i\ l l <br /> npplicant Permitee Signature Date Issued Qy Si n ture L���z,��ate <br />