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' CITY OF ORONO PERMIT NO.: 2oiaoog6s <br /> r ' 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISsuEn: 09/22/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 585 STUBBS BAY RD N <br /> PIN : 32-118-23-24-0006 <br /> LEGAL DESC : UNPLATTED 32 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 3,000.00 <br /> NOTE: 1 RUUD HEATING SYSTEM <br /> PAID WITH 2 CHECKS:#4405 FOR$41.00&#4417 FOR$16.00 <br /> APPLICANT MECHANICAL 50.00 <br /> RONS 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 57.00 <br /> OWNER <br /> FORT,JOHN&KRISTIN <br /> 585 STUBBS BAY RD N <br /> LONG LAKE,MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The wock 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 /> no[grant permission for additional or related work which requires sepazate <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.This permit may be <br /> revoked at any time for�ue cause. <br /> �la�'`'�"'vc � l l <br /> / / <br /> Applicant Permitee Signature Date Issued y ' ature D <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />