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. CITY OF ORONO * 2 0 1 6 - 0 0 1 Z 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/08/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1205 SHORELINE DR <br /> PIN : 02-117-23-43-0015 <br /> LEGAL DESC : REG. LAND SURVEY NO.0397 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 3,600.00 <br /> NOTE: REPLACE: 1 HEATING SYSTEM(CARRIER) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.80 <br /> CENTER POINT ENERGY MINNEGASCO MAIL-IN FEE 2.00 <br /> 9320 EVERGREEN BLVD NW <br /> SUITE B TOTAL 53.80 <br /> COON RAPIDS, MN 55433 Payment(s) <br /> (763)757-6202 CHECK 20113 53.80 <br /> Minnesota State License#: mech-003503 <br /> OW NER <br /> JACKLEY ET AL,JAY M <br /> 1205 SHORF,LINE DR <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 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 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. n�C� <br /> i � <br /> �IW' <br /> J � <br /> � ��C�.� �-��` ���.�-�- �-,a� �`�� �� � , � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />