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CITY OF ORONO * z 0 1 5 — 0 1 2 5 5 * <br /> t 2750 KELLEY PARKWAY DATE ISSUED: 09/29/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 3400 FOX ST <br /> PIN : OS-117-23-43-0005 <br /> LEGAL DESC : FULLERTON ESTATES <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,500.00 <br /> NOTE: REPLACE AN EXISTING HEATING SYSTEM(BRYANT) <br /> APPLICANT MECHANICAL 56.25 <br /> STATE SURCHARGE MECH(VALUATION) 2.25 <br /> ROL AIR PLUMBING&HEATING MAIL-IN FEE 2.00 <br /> 7510 LANNON AVE NE <br /> OTSEGO,MN 55301- TOTAL 60.50 <br /> (763)331-1274 Payment(s) <br /> Minnesota State License#: mech-MB676827 CHECK 2756 60.50 <br /> OWNER <br /> GARNETT, BRAND[ <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 governing 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 construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring alI required inspections are <br /> requested in conformance with the State Building Code.This permit may be �J�� <br /> revoked at any time for due cause. ��W� <br /> � . , /� <br /> �1 � 1 � �'�'� ��"�/\ ��Le �-�L; �i � ��l �/� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />