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CITY OF ORONO * 2 0 1 5 - 0 1 4 7 2 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: l U17/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 375 LEAF ST <br /> PIN : OS-117-23-14-0059 <br /> LEGAL DESC : BAYSIDE WOODS <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 3,395.00 <br /> NOTE: REPLACE HEATING SYSTEM(BRYANT) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.70 <br /> SABRE HEATING&AIR COND INC. MpIL-IN FEE 2.00 <br /> 15535 MEDINA ROAD <br /> PLYMOUTH,MN 55447- TOTAL 53.70 <br /> (763)473-2267 Payment(s) <br /> CREDIT CARD 9764 53.70 <br /> OWNER <br /> GILBERTSON ET AL,MICHAEL R <br /> 375 LEAF ST <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 dces <br /> not grant permission for additional or related work which requires sepazate <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 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 /> 4��� � � �C� v"���f�st� �� � ( 7� / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />