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CITY OF ORONO PERMIT NO.: 2011-01187 <br /> 1 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/04/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 450 WILLOW DR S <br /> PIN : 03-117-23-32-0012 <br /> LEGAL DESC UNPLATTED 03 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE MECHANICAL-MULTIPLE <br /> VALUATION $ 8,000.00 <br /> NOTE: 1 LUZAIRE NAT GAS FURNACE <br /> 1 LUXAIRE 3 TON AC <br /> 3 BATH EXHAUST <br /> APPLICANT MECHANICAL 100.00 <br /> BEN SCHERER PLUMBING&HVAC INC. STATE SURCHARGE MECH(VALUATION) 4.00 <br /> 4520 85TH STREET SE <br /> DELANO,MN 55328- TOTAL 104.00 <br /> (763)972-8137 <br /> OWNER <br /> BOWMAN,WILLIAM <br /> 450 WILLOW DR S <br /> LONG LAKE,MN 55356- <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 anme for du�. <br /> Applicant Permitee Signature Date Issued By Sig a ure Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO E. <br />