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� <br /> CITY OF ORONO PERMIT NO.: 2010-00585 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE 1SSUED: 07/15/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1685 CONCORDIA ST <br /> PIN : 17-117-23-22-0022 <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 016 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 7,000.00 <br /> NOTE: 1 CARRIER NAT GAS FURNACE <br /> 1 CARRIER 4 TON AC <br /> APPLICANT <br /> MECHANICAL 87.50 <br /> RESIDENTIAL HEATING&AIR, INC. STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 1815 EAST 41ST STREET SUITE A <br /> MINNEAPOLIS,MN 55407- MAIL-IN FEE 2.00 <br /> (612)724-1899 MISC FEE 0.00 <br /> TOTAL 94.50 <br /> OWNER <br /> PALM, MR.&MRS. TOM <br /> 1685 CONCORDIA ST <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 not specitied 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 a[any time for due cause. <br /> \�Yt,.lL'�'[ �M / / / / <br /> Applicant Permitee Signature Date Issued Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />