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CITY OF ORONO PERMIT NO.: 2011-01289 <br /> � ' 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEu: 10/2U2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1205 DICKENSON ST <br /> PIN : 02-117-23-31-0040 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK 016 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 9,500.00 <br /> NOTE: (1)CARRIER HEATING SYSTEM <br /> MODEL-�SMXt3040-NATURAL GAS-2" PVC FLUE-40,000 INPUT,37,200 OUTPUT, 1200 CFM <br /> (1)CARRIER COOLING SYSTEM <br /> MODEL-24ALL318- 1/1/2 TONS <br /> GASL[NL FOR ADDf'f[ON <br /> APPLICANT MECHANICAL 118J5 <br /> DITTER INC. STATE SURCHARGE MECH (VALUATION) 4.75 <br /> 820 TOWER DRIVE TOTAL 123.50 <br /> MEDINA, MN 55340 <br /> (763)478-9558 PA[D WITH CC# 7149 <br /> OWNER <br /> WOTIPKA, LINDA A& LEE A <br /> 9908 NW 20TH ST <br /> PEMBROKE PINES, FL 33024- <br /> AGREEMENT AND SWORN STATEMENT <br /> The�vork for which this permit is issued shall be performed according to <br /> the approved plans and speciftcations,applicable City approvals,and thc <br /> State[3uilding Code. This permit is for only die work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinanccs govcrning this type of work <br /> shall be compied with whether or not specitied herein.This permit will <br /> eapire and become null and void if construction authorized is not <br /> commenced���ithin I80 days of the datc of issuance,or if construction is <br /> suspended for a pe iod of 180 days at any time after work has commenced. <br /> Che applicant is ponsible for �suring all rcquircd inspections are <br /> requested in c f rmance wi � 'tate Building Code.This permit may be <br /> revoked at a � me(br d cau <br /> ` , � �U � .�? 1 � Cf �i /I � �/ l // <br /> App � t Permitee. ' nature Date Issu � }3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />