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CITY OF ORONO PERMIT NO.: 2011-00351 <br /> ^ 2750 KELLEY PARKWAY <br /> � <br /> ORONO, MN 55356- �ATE IssUEn: OS/17/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2920 SOMERSET LA <br /> PIN : 04-117-23-21-0012 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN <br /> : LOT 005 BLOCK 003 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 4,455.00 <br /> NOTE: 1 CA3ZRIGR�"fON AC <br /> APPLICANT MECHANICAL 55.69 <br /> FLARE HEATING&AIR COND STATE SURCHARGE MECH (VALUATION) 2.23 <br /> 9309 PLYMOUTH AVE N <br /> SUITE 104 MAIL-IN FEE 2.00 <br /> GOLDEN VALLEY, MN 55427 MISC FEE 0.00 <br /> (763)542-1166 TOTAL 59.92 <br /> OWNER <br /> FIRST, LANCE& MEREDITH <br /> 2920 SOMERSET LA <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permil is issued shall be perfonned according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type oPwork <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 4 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 /> �/�V� <br /> �~ � � - / / <br /> Applica�it Permitee Signature Date Issued [�y Sig re ate <br /> - SEPARATE PERMITS REQUIRED FOR WOF:K OTHER T AN DESCRIBED ABOV <br /> , <br /> i <br />