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. CITY OF ORONO * Z pJ 1 2 — 0 fd B 5 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/18/2012 <br /> '' ORONO,MN 55356- <br /> (952)249-4600 FAX: (952 249-4616 <br /> ADDRESS : 4205 NORTH SHORE DR <br /> PIN : 07-117-23-43-0004 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMTT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 8,000.00 <br /> NOTE: ORIGINAL GEOTI-IERMAL PERIVINIT WAS ISSUED 1 U2007 <br /> THIS PERMIT IS FOR ADDITIONAL LOOP FIELDS ADDED TO THE EXISTING LOOP FIELDS <br /> APPLICANT MECHANICAL 100.00 <br /> GENZ-RYAN PLUMBING&HEAT STATE SURCHARGE MECH(VALUATIOI� 4.00 <br /> 2200 HIGHWAY 13 <br /> BURNSVILLE,MN 55337 MAIL-IN FEE 2.00 <br /> (952)767-1000 TOTAL 106.00 <br /> OWNER <br /> KOEHLER,TIMOTHY&DANIELLE <br /> 4205 NORTH SHORE DR <br /> MOi1ND,MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he 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 dces <br /> not gant permission for additional or related work which requires separaie <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.l'his 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 180 days at any time after work has commenced. <br /> 1'he applicant is responsible for assuring all required inspections ate <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for dqe cause. <br /> �...�v�"'�v l l l l <br /> Applicant Pe�'tee Signature Date <br /> Issued By Si ture Date <br /> SEPARATE PERMITS REQUIItED FOR WORK OTHER THAN DESCRIBED AB . <br />