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� � CITY OF ORONO * Z 0 1 6 - 0 1 5 1 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/OS/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3440 SHORELINE DR <br /> PIN : 17-117-23-43-0142 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 022 BLOCK 006 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> COIYSTRUCTIOIV TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 4,000.00 <br /> NOTE: ALL TEST[NG REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> FURNACE REPLACEMENT <br /> APPLICAI�IT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 2.00 <br /> TEAM MECHANICAL&SOUTH MPLS PLUMBI <br /> 3560 SNELLING MAIL-IN FEE 2.00 <br /> MINNEAPOLIS, MN 55406 TOTAL 54.00 <br /> 612-473-7446 Payment(s) <br /> CHECK 20500 54.00 <br /> OWNER <br /> BLOOMQUIST, RICHARD <br /> POBOX831 <br /> ST BONIFAC[US, MN 55375- <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 pennission for additional or related work which requires separate <br /> pernlits. 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 afrer 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 /> /� v l/1% <br /> Ap icant Permitee Signature Date IssuedtBy Sig ure Date <br />