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�� <br /> I T �` CITY OF ORONO <br /> 2750 KELLEY PARKWAY * z 0 1 4 - 0 0 6 3 Z * <br /> �� DATE ISSUED: 06/20/2014 <br /> i, ORONO, MN 55356- <br /> ! (952)249-4600 FAX: (952) 249-4616 <br /> I DDRESS : 3115 SUSSEX RD <br /> IN : 04-117-23-32-0015 <br /> EGAL DESC : FOX BEND <br /> : LOT 004 BLOCK 002 <br /> ERMIT TYPE : MECHANICAL(>$500) <br /> ROPERTY TYPE : RESIDENTIAL <br /> ONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> ALUATTON : $ 3,500.00 <br /> OTE: VENT(1)KITCHEN EXHAUST <br /> TEND GAS L[NE TO RANGE <br /> APPLICANT MECHANICAL 50.00 <br /> CTICAL SYSTEMS STATE SURCHARGE MECH(VALUATION) 1.75 <br /> 4 2B SHADY OAK RD MAIL-IN FEE 2.00 <br /> PK1NS, MN 55343 TOTAL 53.75 <br /> ( 2)933-1868 Payment(s) <br /> CREDIT CARD 0961 53.75 <br /> OWNER <br /> RY RASKOB, DANIEL DELMORE& <br /> � 3 5 SUSSEX RD <br /> L G LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> T work for which this permit is issued shall be performed according to <br /> th pproved plans and specifications,applicable City approvals,and the <br /> St Building Code. This permit is for only the work described and does <br /> n rant permission for additional or related work which requires separate <br /> pe its. All provisions of laws and ordinances goveming this type of work <br /> sh be compied with whether or not specified herein.This permit will <br /> ex e and become null and void if construction authorized is not <br /> � co enced within 180 days of the date of issuance,or if construction is <br /> su nded for a period of 180 days at any time after work has commenced. <br /> ' Th pplicant is responsible for assuring all required inspections are <br /> re sted in conformance with the State Building Code.This permit may be <br /> re ed at any time for due cause. <br /> y���� 6?3 � � � zv � � � <br /> A icant Permitee Signature ate Iss d By Signature Date <br />