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" '� CITY OF ORONO <br /> 2750 KELLF,Y PARKWAY * � 0 1 4 - 0 1 4 0 z * <br /> DATE ISSUED: 12/08/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3010 SOMERSET LA <br /> PIN : 04-117-23-22-0029 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUAT[ON : $ 16,000.00 <br /> NOTE: (1)LENNOX FURNnCG AND A/C <br /> APPLICAI�IT MECHANICAL 200.00 <br /> STATE SURCHARGE MECH (VALUATION) 8.00 <br /> GOLDEN VALLEY HEATING&AIR MAIL-IN FEE 2.00 <br /> 5182 WEST BROADWAY <br /> CRYSTAL, MN 55429- TOTAL 210.00 <br /> (612)535-2000 Payment(s) <br /> CREDIT CARD 7420 210.00 <br /> OWNER <br /> CARSON, WALLACE&SHARYL <br /> 3010 SOMERSE"I' LA <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perYormed according to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for a'dditional 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.'rhis 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 rcquircd inspections are <br /> requested in conformance with the State E�uilding Code.This pe it may be <br /> revoked at any time for due cause. <br /> � <br /> � l�' l � �� � ' v�-u-�--- /.z � � �/ <br /> Applicant Permitee Signa ure te Issue By Signature Date <br />