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CITYOFORONO * 2012 - 00509 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/08/2012 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1055 FERNDALE RD W <br /> PIN : 02-117-23-43-0029 <br /> LEGAL DESC : N/A <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 6,485.00 <br /> NOTE: I LENNOX NATURAL GAS FURNACE <br /> I LENNOX 3 TON AC <br /> APPLICANT MECHANICAL 81.06 <br /> SELECT MECHANICAL SERVICES INC. STATE SURCHARGE MECH(VALUATION) 3.24 <br /> 6219 CAMBRIDGE ST <br /> ST. LOUIS PARK, MN 55416- MAIL-[N FEE 3.76 <br /> (952)926-4488 TOTAL 88.06 <br /> OWNER <br /> MCCOURTNEY, GERALD& KAREN <br /> 1055 FERNDALE RD W <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 specitications,appiicable 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 180 days of the date of issuance,or if construction is <br /> suspended for a period of l 80 days at any[ime 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 due cause. <br /> `_l�a-� `'� l l l l <br /> Applicant Permitee Signature Uate Issued By S' ature ate <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABO . <br />