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; <br /> � CITY OF ORONO * Z pJ 1 6 - 0 1 0 7 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/0112016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1209 FRENCH CREEK DR <br /> PI[� : 10-117-23-23-0002 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 4,300.00 <br /> NOTE: (1)DAIK[N COOLING SYSTEM <br /> APPLICANT MECHANICAL 53.75 <br /> CENTERPOINT ENERGY STATE SURCHARGE MECH(VALUAT[ON) 2.15 <br /> 6161 GOLDEN VALLEY RD MAIL-IN FEE 2.00 <br /> BUILDING A TOTAL 57.90 <br /> GOLDEN VALLEY, MN 55422- Payment(s) <br /> (763)512-2765 CHECK 20520 57.90 <br /> Minnesota State License#: mech-MB003503 <br /> OWNER <br /> JACOBS, MELINDA <br /> 1209 FRENCH CREEK DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work Yor 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 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 I 80 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 State Building Code.This permit may be <br /> revoked at any time tor due cause. <br /> C�.�{�+��� ` ��� ���o <br /> Applicant Permitee Signature Date I ue Signature Date <br />