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, CITY OF ORONO * z 0 1 3 - 0 1 1 7 B * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 1 U04/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1405 SIXTH AVE N <br /> PIN : 35-118-23-22-0006 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.291 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 1,800.00 <br /> NOTE: 1 CAYENNE NAT GAS HEATING SYSTEM <br /> APPLICANT MECHANICAL 50.00 <br /> UMR GEOTHERMAL STATE SURCHARGE MECH(VALUATIQN) 0.90 <br /> 5115 INDUSTRIAL STREET <br /> MAPLE PLAIN,MN 55359 MAIL-IN FEE 6.10 <br /> (763)479-6325 TOTAL 57.00 <br /> OWNER <br /> CERNY,JOSEPH&INGER <br /> 1405 SIXTH AVE N <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfortned 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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of 1 SO 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.This permit may be <br /> revoked at any time for due cn�use. <br /> / ��-Qt� �NL' / / / / <br /> Applicant Permitee Signature Date Issued By Si re Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />