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CITY OF ORONO PERMIT NO.: 2011-00104 <br /> . 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- DATE ISSUED: 02/15/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 350 CRESTVIEW AVE <br /> PIN : OS-117-23-14-0057 <br /> LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK <br /> : LOT 000 BLOCK 006 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 3,000.00 <br /> NO'll�,: 1 RUUD Nn"I�GAS FURNACF. <br /> ( <br /> APPLICANT MECHANICAL 50.00 <br /> RON'S MECHANICAL, INC. STATE SURCHARGE MECH (VALUATION) 5.00 <br /> 12010 OLD BRICK YARD ROAD <br /> SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 <br /> (952)445-8585 MISC FEE 0.00 <br /> TOTAL 57.00 <br /> OWNER <br /> STEPHENS III ET AL, WINFIELD R <br /> 3770 BAYSIDE RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he���ork for���hich this pennit is issucd shall be performed according to <br /> the approved plans and specitications,�pplicable City approvals,and the <br /> State[3uilding Code. "fhis permit is for only thc�eork described and docs <br /> not erant permission for additional or related work which requires scparate <br /> permits. All provisions of laws and ordinances goveming this type of���ork <br /> shall be compied with whether or not spccihed herein.'Chis permit�vill <br /> ezpire and become null and void if construction aulhorized is not <br /> commenced�cithin 180 days of the date of issuance,or if construction is <br /> suspended lor a period of 180 days at any time after���ork has commenccd. <br /> The applicant is responsible for assurinc all required inspections are <br /> requested in confonnance with the Slate I�uilding Code.This permit may be <br /> revokcd at any time for due cause. <br /> / / / / <br /> Applicant Pennitee Signature Date Issued B ignature �ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />