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* CITY OF ORONO * Z 0 1 6 - 0 0 0 4 7 * <br /> �, 2750 KELLEY PARKWAY DATE ISSUED: OU14/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3400 FOX ST <br /> PIK : OS-117-23-43-0005 <br /> LEGAL DESC : FULLERTON ESTATES <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,500.00 <br /> NOTE: REPLACEMENT OF ONE OF THE HEATING SYSTEMS IN THE HOME(BRYANT) <br /> APPLICANT MECHANICAL 56.25 <br /> STATE SURCHARGE MECH(VALUAT[ON) 2.25 <br /> ROL AIR PLUMBING&HEATING MAIL-IN FEE 2.00 <br /> 11792 272ND AVE NW <br /> ZIMMERMAN,MN 55398- TOTAL 60.50 <br /> (763)248-8909 Payment(s) <br /> Minnesota State License#: mech-MB676827 CREDIT CARD 5148 60.50 <br /> OWNER <br /> GARNETT,BRANDI <br /> 3400 FOX ST <br /> LONG LAKE, MN 55356- <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 goveming this rype 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 construc[ion 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 5tate Building Code.This permit may be <br /> revoked at any time for due cause. <br /> _ t�� , � <br /> ����� ���'� � .� �t���� ��� �� �l , �. �� , � � � �� � , <br /> I � � '�. , �1_ � -� � W l <br /> Applicant Permitee SignatureT— Date Issued By Signa�{tre Date <br />