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IIYIi111 � �'� I �1I1' I CITY OF ORONO * 20 1 3 - 00 1 29 * 2750 KELLEY PARKWAY DATE ISSUED: 02/25/2013 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 890 OLD CRYSTAL BAY RD S PIN : 09-117-23-12-0008 LEGAL DESC : FRENCH CREEK WOODS : LOT 004 BLOCK 001 PERMIT TYPE : MECHANICAL(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULTIPLE VALUATION : $ 9,026.50 NOTE: (2)KENMORE HEATING SYSTESM MODEL#G8MVL0701412A NATURAL GAS 70,000 INPUT BTU'S 56,000 OUTPUT BTU'S APPLICANT MECHANICAL 112.83 KNIGHT HEATING&AIR COND STATE SURCHARGE MECH(VALUATION) 4.51 13535 89TH ST-NE- MAIL-INMAIL-IN FEE 2.00 OTSEGO,MN 55330 (763)274-9945 TOTAL 119.34 OWNER TROUP,JOHN&MARGARET 890 OLD CRYSTAL BAY RD S WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due use. o?% , s, 0 /A5//3 Applicant Permitee Signature Date Issued y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.