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, <br /> , CITY OF ORONO PERMIT IVO.: 2009-00744 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISS[7En: 10/2U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3600 CASCO AVE <br /> PIIv : 20-117-23-31-0042 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1115 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 3,700.00 <br /> NOTE: 1 LENNOX GAS HEATING SYSTEM <br /> APPLICANT MECHANICAL 50.00 <br /> SEDGWICK HEATING&AIR COND INC. STATE SURCHARGE MECH(VALUATION) 1.85 <br /> 8910 WENTWORTH AVE S <br /> MINNEAPOLIS, MN 55420- MAIL-IN FEE 2.00 <br /> (612)881-9000 MISC FEE � 0.00 <br /> TOTAL 53.85 <br /> OWNER <br /> HAEFELE, RICHARD <br /> 3600 CASCO AVE <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 no[specified herein.This permit will <br /> expire and become null and void if construction authorized is no[ <br /> commenced within 180 days of[he 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 dye cause.- <br /> `��'✓....�.� l�Vl. l l ��' v�-�--►�� l l <br /> Applicant Permitee Signature Date Issued By Si ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />