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CITY OF ORONO * 2 0 1 6 - 0 0 0 3 3 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: OU1U2016 <br /> • ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3480 SHORELINE DR <br /> PIN : 17-117-23-43-0093 <br /> LEGAL DESC : NAVARRE HEIGHTS <br /> : LOT 017 BLOCK 006 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 3,446.00 <br /> NOTE: REPLACE HEATING SYSTEM(LENNOX) <br /> APPLICANT MECHANICAL 50.00 <br /> SEDGWICK HEATING&A/C STATE SURCHARGE MECH(VALUATION) 1.72 <br /> 1408 NORTHLAND DR- SUITE 310 MAIL-IN FEE 2.00 <br /> MENDOTA HEIGHTS,MN 55118- TOTAL 53.72 <br /> (952)881-9000 Payment(s) <br /> CHECK 16316 53.72 <br /> OWNER <br /> BLOCK,JAMES <br /> 3480 SHORELINE DR <br /> MINNETONKA,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 onty 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 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 a[any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> reques[ed in conformance with the State Building Code.This permit may be � <br /> revoked at any time for due cause. � � �i..��.! <br /> �� � � - <br /> � {��i ' .. z���� ��� � ��,� �') � � ,��-�_� � / � �� i <br /> G� � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />