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-. CITY OF ORONO PERMIT NO.: 2011-00955 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE lssuEn: 08/29/20ll <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2740 KELLY AVE <br /> PIN : 21-117-23-23-0037 <br /> LEGAL DESC : VERN-MAR MANOR <br /> : LOT 012 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : VENTILATION <br /> VALUATION : $ 2,400.00 <br /> NOTE: 3 BATH EXHAUST FANS <br /> APPLICANT MECHANICAL 50.00 <br /> WILLIAM H. GILBERTSON LLC STATE SURCHARGE MECH(VALUATION) 1.20 <br /> 5910 HAWTHORNE RD <br /> MOLJND, MN 55364- TOTAL 51.20 <br /> (6l2)702-3428 <br /> OWNER <br /> O'MALLEY, PHYLL[S <br /> 2740 KELLY AVE <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AI�D SWORN 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 permission for additional or related work which requires separate <br /> pcnnits. 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 consVuction 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 with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � ���-r,������-�L�� `� i ` I i / / <br /> i i <br /> Applicant Permitee Signature Date Issued By Sig ure Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />