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CITYOFORONO * z0 15 - 0083Z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/30/2015 <br /> ' ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2715 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 003 <br /> PERM[T TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULT[PLE <br /> VALUATION : $ 13,399.00 <br /> NOTE: 1 HEATING& 1-COOLING SYSTEMS <br /> APPLICANT MECHANICAL 167.49 <br /> STATE SURCHARGE MECH(VALUATION) 6.70 <br /> PRONTO HEATING&AC MAIL-IN FEE 2.00 <br /> 7588 WASHINGTON AVE S <br /> EDEN PRAIRIE, MN 55346- TOTAL 176.19 <br /> (952)835-7777 Payment(s) <br /> CHECK 10632 176.19 <br /> OWNER <br /> WILSON, MARK&KIRSTIN <br /> 2715 COUNTRYSIDE DR W <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 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 l80 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 /> reques[ed in conformance with the Sta[e Building Code.This permi[may be '] <br /> revoked at any time for due cause. � }� ('� <br /> � .. <br /> 1 " J` � <br /> , . <br /> _ . \ ,� � � <br /> � <br /> � <br /> i l � .� I �S�-�-� . �,c -:.�� � �; �r, J�, � <br /> Applicant Permitee Signa re � Date Issued By Sig re Date <br />