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, � <br /> CITY OF ORONO PERMIT NO.: 2009-00648 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �SSUEu: 09/30/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 980 FERNDALE RD W <br /> PIN : 02-117-23-44-0019 <br /> LEGAL DESC : COUNTRY CLUB ESTATES <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE . � v -MULTIPLE <br /> VALUATION : $ 6,000.00 <br /> NOTE: HF.ATING SYSTEM-NATURAL GAS-3"FLUE,84,800 INPUT BTU'S,CFM-BOILER <br /> GASLINES FOR OUTDOOR GRILL AND DRYGR <br /> APPLICANT MECHANICAL 75.00 <br /> SAFAR,JACK& PAMELA STATE SURCHARGE MECH (VALUAT[ON) 3.00 <br /> 980 FERNDALE RD W <br /> WAYZATA, MN 55391- TOTAL 78.00 <br /> OWNER <br /> SAFAR, JACK& PAMELA <br /> 980 FERNDALE RD W <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work tor which this 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 1 SO days at any time after work has commenced. <br /> The applicant esponsible for assuring all required inspections are <br /> requestcd i for nce with the Sta[e Building Code.This permit may bc <br /> revoked ny t�m or due cause. <br /> � / / / / <br /> pplicant Permitee Signaturc Date Issued By Signature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />