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' ' PERMIT <br /> CITY OF ORONO Permit Number: <br /> 2750 Kelley Parkway - PO Box 66 P06883 <br /> Crystal Bay, Minnesota 55323 Permit Type: 1v�echanical Permits <br /> (952) 249-4600 Date Issued: io�io�2oo3 <br /> SITE ADDRESS: 66 Hackberry Hill <br /> I.ong Lake,MN 55356 <br /> PI D: 33-118-23-44-0024 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Pernut Class: General <br /> Permit Type: Mechanical Permits Pernut Sub-type(s): Gas Fireplace <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate pernuts required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 2,200.00 <br /> State Surcharge Fee: $ 1.10 <br /> TOTAL FEE: $ 36.10 <br /> APPLICANT: Countryside Heating&Cooling OWNER: Jeanette Henderson <br /> 6511 Hwy 12 66 Hackberry Hill <br /> Maple Plain,MN 55359 Long Lake,MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> /� �� / <br /> i� L lZ-��G� �— �/C� �c <br /> / --z.�-� � �� ( _-��—,c�--- t'/S�l �--) <br /> APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE <br /> CoUies: 1-File(SiQnftures Required), 1-AUUlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 <br />