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T • <br /> CITY OF ORONO * z 0 1 z - 0 0 7 8 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/14/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 915 FOREST ARMS LA <br /> PIN : 07-117-23-12-0018 <br /> LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> VALUATION : $ 6,000.00 <br /> NOTE: (1)BRYANT HGATING SYSTEM <br /> MODEL-386TA-NATURAL GAS-2"PVC-8Q000 INPUT,78,000 OUTPUT B"I�U'S- 1600 CFMS <br /> (10 BRYANT COOLING SYSTEM-MODGL- 126BNn-2.5"I ONS-25 AMP <br /> APPLICANT MECHAN[CAL 75.00 <br /> COUNTRYSIDE HEATING& COOLING STATE SURCHARGE MECH(VALUATION) 3.00 <br /> 6511 HWY 12 <br /> MAPLE PLA[N, MN 55359 TOTAL 78.00 <br /> (763)479-1600 PAID WITH CC# 1067 <br /> OWNER <br /> BELAWSKI&AARON RUSS,JAMIE <br /> 915 FOREST ARMS LA <br /> MOUND, MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> l hc work for which this permit is issucd shall be performcd according to <br /> thc approvcd 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 rcquires 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 /> requeste in conformance with the Statc[3uilding Code.This permit may be <br /> revoke �t any tim f e cause. <br /> � � � � � �l /`�7 �a� <br /> Applicant Permitce Signature Date Issu By Signalure Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />