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, . ? CITY OF ORONO * z 0 1 5 - 0 1 0 9 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/27/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4470 FOREST LAKE LANDING <br /> PIN : 07-117-23-24-0040 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1472 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 6,683.00 <br /> NOTE: (1)BRYANT FURNACE AND(1)BRYANT A.0 <br /> APPLICANT MECHANICAL 83.54 <br /> STATE SURCHARGE MECH(VALUATION) 3.33 <br /> ANGELL AIRE INC. MAIL-IN FEE 2.00 <br /> 12253 NICOLLET AVE <br /> BURNSVILLE, MN 55337 TOTAL 88.87 <br /> (952)746-5200 Payment(s) <br /> Minnesota State License#: mech-MB003386 CHECK 29179 88.87 <br /> OWNER <br /> PRAWER, STEVEN & SCOTT <br /> 4470 FOREST LAKE LANDING <br /> MOLTND, MN 55364- <br /> AGREEMENT AIYD 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 Iaws and ordinances governing this type of work <br /> shall be compied wi[h whether or not specified herein.This permit will <br /> expire and become null and void if construc[ion authorized is not <br /> commenced within 180 days of[he 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 aze <br /> reques[ed in conformance with the S[ate Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � <br /> � � � � ��/ �� <br /> Applicant Permitee Signature ' Date Issued B gnature Date <br />