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CITY OF ORONO * 2 0 1 3 - 0 1 2 9 4 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/16/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 825 OLD CRYSTAL BAY RD S <br /> PIN : 09-117-23-21-0001 <br /> LEGAL DESC : UNPLATTED 09 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE ) McC14-1e.-e <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FSE ,414419" 51 S19rNs__ <br /> NOTE: (1)LENNOX HEATING SYSTEM ` <br /> VALUATION OF PLUMBING 3940 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.97 <br /> SELECT MECHANICAL SERVICES INC. MAIL-IN FEE 2.00 <br /> 6219 CAMBRIDGE ST <br /> ST.LOUIS PARK,MN 55416- TOTAL 53.97 <br /> (952)926-4488 Payment(s) <br /> CHECK 3496 53.97 <br /> OWNER <br /> DAYTON,JUDSON&ELIZABETH <br /> 121 S 8TH STREET#860 <br /> MINNEAPOLIS, MN 55402- <br /> AGREEMENT AND 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 /> 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 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 /> 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 /> (-71/Lidej / �4 /o2--ii /' //3Applicant Permitee Si ne Date Issu By Signature Date <br />