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,, �1 CITY OF ORONO * 2 0 1 3 - PJ 0 3 9� <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/22/2013 <br /> , ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3472 SHORELINE DR <br /> PI1V : 17-117-23-43-0094 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 018 BLOCK 006 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 3,150.00 <br /> NOTE: 1 ARMSTRONG 2 TON AC <br /> APPLICANT <br /> MECHANICAL 50.00 <br /> SEDGWICK HEATING&A/C STATE SURCHARGE MECH(VALUATION) 1.58 <br /> 1408 NORTHLAND DR- SUITE 310 <br /> MENDOTA HEIGHTS,MN 55118- MAIL-IN FEE 2.00 <br /> (952)881-9000 TOTAL 53.58 <br /> OWNER <br /> BLOCK,JAMES <br /> 3472 SHORELINE 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 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 wnstruction 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due caus� <br /> i�K� � / / C�;�'�l.Qy�_ l l <br /> Applicant Permitee Signature Date Issued By ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />