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, � <br /> � CITY OF ORONO * z 0 1 4 - 0 1 0 2 e * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/1U2014 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1380 FRENCH CREEK DR <br /> PIN : 10-117-23-32-0009 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,300.00 <br /> NOTG: 1 RHGGM-NA'I'CRAL GAS <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 1.15 <br /> WESTAIR HEATING MAIL-IN FEE 2.00 <br /> 11 184 R[VER ROAD NE <br /> HANOVER, MN 55341 TOTAL 53.15 <br /> (763)498-8071 Payment(s) <br /> CHECK 18979 53.15 <br /> OWNER <br /> PALOMBO,JOHN&SUSAN <br /> 1380 FRENCH CREEK DR <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORIv STATEMENT <br /> The work for 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 perniission 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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> I he applicant is responsible for assuring all required inspections are <br /> reques[ed in conformance with the State Building Code.This pennit may be <br /> revoked at any[ime for due cause. <br /> C <br /> ���� � �- � c-�, ��' / � <br /> Applicant Permitee Signature Date sued y Signature � Date <br />