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� CITY OF ORONO * Z 0 1 5 - PJ PJ 5 7 3 * <br /> �' 2750 KELLEY PARKWAY DATE ISSUED: OS/11/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 261 CYGNET PL <br /> PIN : 04-117-23-23-0013 <br /> LEGAL DESC : SWAN LAKE ADDN <br /> : LOT O10 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 5,621.00 <br /> NOTE: 1 HEAT[NG SYSTEM(LENNOX)& 1 COOLING SYSTEM(LENNOX) <br /> APPLICANT MECHANICAL 70.26 <br /> STATE SURCHARGE MECH(VALUATION) 2.81 <br /> MARSH HEATING&AIR COND MAIL-IN FEE 2.00 <br /> 6248 LAKELAND AVE N <br /> MINNEAPOLIS,MN 55428- TOTAL 75.0'7 <br /> (763)536-0667 Payment(s) <br /> Minnesota State License#: mech-MB003532 CHECK 85738 75.07 <br /> OWNER <br /> CARSWELL, KIM <br /> 261 CYGNET PL <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his permit is issued shall be performed according to <br /> the 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 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 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 applican[is responsible for 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 cause. <br /> � �� <br /> �� U�'Y� Ce-�'1 � l�� l �'S _ <br /> Applicant Permitee Signature ate Issued By Signature Date <br />