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CITY OF ORONO * 2 PJ 1 2 — fd 0 3 0 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/19/2012 <br /> ORONO, MN 55356- <br /> ' (952) 249-4600 FAX: (952) 249-4616 <br /> ADQjcESS : 3800 DICKSON EXTENSION <br /> PIN : 17-117-23-31-0020 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 001 BLOCK O10 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,100.00 <br /> NOTE: 1 COLEMAN NAT GAS PURNACF, <br /> APPLICANT MECHANICAL 50.00 <br /> A[R JEFF'S HEAT[NG &AIR CONDITIONI STATE SURCHARGE MECH (VALUATION) 1.05 <br /> 3028 WESTEDGE BLVD <br /> MOUND, MN 55364- TOTAL 51.05 <br /> (952)270-0668 <br /> OWNER <br /> ADAM BLAIR, KELLY HARRISON/ <br /> 3800 DICKSON EXTENSION <br /> SPRING PARK, MN 55384- <br /> AGREEMENT AND SWORIY STATEMEIVT <br /> The work for which this permit is lssued shall be performcd according to <br /> the approved plans and speciYications,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 wi[h whether or not speciYied 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 for assuring all required inspections are <br /> requested in conformance wit the S ate Building Code.This permit may be <br /> revoked at any ti e due use. � <br /> i /. <br /> ! , � � � � �� t-�-� ���� � � <br /> Applica t tee Signat re Date Issued By, i nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHEfi� HAN DESCRIBED ABO E. <br />