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� CITY OF ORONO PERMIT NO.: 2009-00739 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 10/20/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4205 NORTH SHORE DR <br /> PIN : 07-117-23-43-0004 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 1,775.00 <br /> NOTE: 1 CAIVIER ELECTRIC HEATING SYSTEM <br /> APPLICANT �CHANICAL 50.00 <br /> GENZ-RYAN PLUMBING&HEAT STATE SURCHARGE MECH(VALUATION) 0.89 <br /> 2200 HIGHWAY 13 <br /> BURNSVILLE,MN 55337 MAIL-IN FEE 2.00 <br /> (952)767-1000 MISC FEE 0.00 <br /> TOTAL 52.89 <br /> OWNER <br /> PETERSON,MARY JO <br /> 4205 NORTH SHORE DR <br /> MOiJND,MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this percnit 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 does <br /> not grant permission for additional or related work which requires separate <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 aze <br /> requested in conformance with�the State Building Code.1'his permit may be <br /> revoked at any time fo�due cause. <br /> �l�iZ�(,(.t�' L�1. l l <br /> i i <br /> Applicant Permitee Signature Date Issued By S' ature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABO . <br />