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CITY OF ORONO * 2 0 1 3 — 0 0 8 3 6 * <br /> � 2750 KELLEY PARKWAY �ATE lssuE�: 08/2U2013 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4650 CREEKWOOD TR <br /> PIN : 30-118-23-33-0006 <br /> LEGAL DESC : PAINTERS WOODS <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 16,300.00 <br /> NOTE: 2 LENNOX NAT GAS FURNACES <br /> 2 LENNOX ACS <br /> APPLICANT MECHANICAL 203.75 <br /> GOLDEN VALLEY HEATING& AIR STATE SURCHARGE MECH(VALUATION) 8.15 <br /> 5182 WEST BROADWAY <br /> CRYSTAL, MN 55429- MAIL-IN FEE 2.00 <br /> (6l2)535-2000 MISC FEE 0.00 <br /> TOTAL 213.90 <br /> OWNER <br /> BJORK, KEVIN & LORI <br /> 4650 CREEKWOOD TR <br /> MAPLE PLAIN, MN 55359 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and speciflcations,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 I�ws and ordinances governing this type of work <br /> shall be compied with whe[her or not specified 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 fbr 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 /> �i��/� r/{'l / / / / <br /> Applicant Permitee Signature Date Issued y Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />