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` CITY OF ORONO PERMIT NO.: 2009-00792 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 1U05/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1]0 CREEK RIDGE PASS <br /> PIN : 03-117-23-12-0015 <br /> LEGAL DESC : CREEKSIDE IN ORONO <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 27,000.00 <br /> NOTF,: 2 WATER FURNACE ELECTRIC HEATING SYSTF-,M-GL07�HERMAL <br /> 1 TRIANGLE TUBE NAT.GAS HEATING SYSTEM <br /> 1 WATER FURNACE 6 TON AC <br /> APPLICANT MECHANICAL 337.50 <br /> UMR GEOTHERMAL STATE SURCHARGE MECH(VALUATION) 13.50 <br /> 5115 INDUSTR[AL STREET <br /> MAPLE PLAIN, MN 55359 MAIL-IN FEE 2.00 <br /> (763)479-6325 TOTAL 353.00 <br /> OWNER <br /> JOHNSON,ANDREW <br /> 4215 TRILLIUM LN E <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 rela[ed 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 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 applican[is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at �time for due cause. <br /> // i a� Dq � �� <br /> Applicant Permitee Sign re Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK THER THAN DESCRIBED ABOVE. <br />