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CITY OF ORONO * Z 0 1 2 — 0 PJ 3 1 6 * <br /> ` 2750 KELLEY PARKWAY ppT� �ssv�u: 04/23/2012 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1937 FAGERNESS POINT RD <br /> PIN : 17-117-23-23-0012 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 020 BLOCK 000 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 2,287.00 <br /> NOTE: 1 BRYANT 2.5 TON AC <br /> APPLICANT <br /> MECHANICAL 50.00 <br /> STANDARD HEATING& AIR CONDITIONING STATE SURCHARGE MECH (VALUATION) 1.14 <br /> 130 PLYMOUTH AVENUEN. <br /> M[NNEAPOLIS, MN 55411- MAIL-IN FEE 2.00 <br /> 612-824-2656 TOTAL 53.14 <br /> OWNER <br /> ROBERTS, RICHARD <br /> 1937 FAGERNESS PT RD <br /> WAYZATA, MN 55391 <br /> AGREEMEIYT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according ro <br /> �the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This pemiit is for only the work described and does <br /> no[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 whe[her 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 l80 days a[any time atter work has commenced. <br /> The applicant is responsible Yor 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 /> �,Lr� �'�� l l <br /> � / / <br /> Applicant Permitee Signature Date lssued B ignature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />