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� �* CITY OF ORONO * 2 0 1 4 - 0 1 2 5 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/27/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1510 GREEN TREES RD <br /> PIN : 11-117-23-23-0015 <br /> LEGAL DESC : GREEN TREES ON TANAGER LAKE <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : KESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULT[PLE <br /> VALUATION : $ 6,500.00 <br /> NO"I�E: (2)CARRII?R FURNACE;S <br /> APPLICANT MECHANICAL 81.25 <br /> STATE SURCHARGE MECH(VALUATION) 5.00 <br /> APPLIANCE CONNECTIONS, INC. MAIL-IN FEE 2.00 <br /> 12850 CHESTNUT BLVD <br /> SHAKOPEE, MN 55379- TOTAL 88.25 <br /> (952)445-4803 Payment(s) <br /> Minnesota State License#: mech-MB004165 CHECK 5795 88.25 <br /> OWNER <br /> STEVENSON, SCOTT <br /> 1510 GREEN TREES RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The���ork for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicablc Ciry approvals,and thc <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission for additional or related�vork which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not spccified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenccd within 180 days orthe 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 State Quilding Code."�his permit may be <br /> revoked at any time for due cause. <br /> � �-� /o/i7�� � /a� d7� i� <br /> Applicant Permitce Signature Dat�, �� Issued ,�Signature Date <br />