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CITY OF ORONO �� <br /> * 2 0 1 4 — P1 1 4 0 3 * <br /> � � • 2750 KELLEY PARKWAY pATF lssuE�: 12/08/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3309 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0016 <br /> LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B <br /> : LOT 001 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 11,000.00 <br /> NO'1'I:: (1)LUXAIRE FURNACF,AND A/C <br /> GASLINE FOR(2)FIRF.PLACRS <br /> (1)KITCHEN [?X}IAUS�I� <br /> (4)BATH GXI�IAUST <br /> APPLICANT MECHANICAL 137.50 <br /> STATE SURCHARGE MECH(VALUATION) 5.50 <br /> C& M PLUMBING &HEATING <br /> 610 CENTRAL AVENUE TOTAL 143.00 <br /> BUFFALO, MN 55313- Payment(s) <br /> Minnesota State License#: mech-MB003954 CHECK 7895 � 143.00 <br /> OWNER <br /> SCHMID, DAVID <br /> 3309 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pern�it is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State 13uilding 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 o1�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 I 80 days of the date oY 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 for assuring all required inspections are <br /> rcquested in conformance with th�StAte[�yilding Code.This permit may be <br /> revoked at any time for due cause.,-�'� <br /> / � <br /> c .� , ,�, / L� <br /> f��_s,%/' -t'-, /_./�-CJ � G � '~ l �/ /lX-�/ � /� <br /> npplic�rmitee�ignature Date Issuc y Signature Date <br />