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CITY OF ORONO * 2 0 1 2 - 0 0 9 3 2 * <br /> �' '` � 2750 KELLEY PARKWAY DATE ISSUED: 09/17/2012 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2795 SHADYWOOD RD <br /> PIN : 21-117-23-31-0002 <br /> LEGAL DESC : REG.LAND SURVEY NO.0500 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,900.00 <br /> NOTE: 1 BRYANT NAT GAS FURNACE <br /> APPLICANT MECHANICAL 50.00 <br /> PRECISION HEATING&COOLING INC. STATE SURCHARGE MECH(VALUATION) 1.45 <br /> 3650 CHEST'NUT ST.N <br /> CHASKA,MN 55318 MAIL-IN FEE 2.00 <br /> (952)556-0187 TOTAL 53.45 <br /> OWNER <br /> NAGFACK, SHIRLEY <br /> 2795 SHADYWOOD RD <br /> EXCELSIOR,MN 55331- <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 dces <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming 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 cau�. <br /> `��'�� �' l l ��;Y✓L.`LyL l l <br /> Applicant Permitee Signature Date Issued By nature Dat <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED AB E. <br />