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CITY OF ORONO PERMIT NO.: 2010-00620 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 07/26/2010 <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 450 OLD LONG LAKE RD <br /> PIN : 36-118-23-34-0014 <br /> LEGAL DESC : SUMMIT STATION <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 5,000.00 <br /> NOTE: 1 CARRIER 5 TON AC <br /> APPLICANT MECHANICAL 62.50 <br /> ROWS MECHANICAL,INC. STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 12010 OLD BRICK YARD ROAD <br /> SHAKOPEE,MN 55379 MAIL-IN FEE 2.00 <br /> (952)445-8585 MISC FEE 0.00 <br /> TOTAL 69.50 <br /> OWNER PAID WITH CC# 5443 <br /> POLICINSKI,CHRISTOPHER&ANNE <br /> 450 OLD LONG LAKE RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit 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 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 /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due-cause. <br /> L-Ma <br /> Applicant Permitee Signature Date Issued By ature I Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />