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CITY OF ORONO * Z 0 1 6 — fd 1 3 8 6 * <br /> , -, 2750 KELLEY PARKWAY DATE ISSUED: 1 U01/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2080 SALEM CT <br /> PIN : 27-118-23-31-0016 <br /> LEGAL DESC : DICKEY LAKE ADDN <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : VENTILATION <br /> VALUATION : $ 900.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> DUCTWORK FOR BASEMENT,VENT BATH <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.45 <br /> MATRIX HVAC TOTAL 50.45 <br /> 14226 NORDEN DR <br /> ROGERS,MN 55374 Payment(s) <br /> (763)535-6335 CHECK 2937 50.45 <br /> Minnesota State License#:mech-MB0036761 <br /> OWNER <br /> HIRSCHBERG,LAURA&ROBB <br /> 2080 SALEM CT <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 does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing 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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of I80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conform ce with the State Building Code.This permit may be <br /> revoked at any ti or due cause. <br /> �'����� �� // � D/� l�b <br /> pplicant Permitee Signature Date Iss d By Si ahue Date <br />