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CITY OF ORONO * Z 0 1 6 — 0 1 5 5 2 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 12/19/2016 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3300 FOX ST <br /> PIN : OS-117-23-44-0003 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1358 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 5,800.00 <br /> NOTE: ALL TESTING RENORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> REPLACE HEATING SYSTEM(AMANA) <br /> APPLICANT MECHANICAL 72.50 <br /> STATE SURCHARGE MECH(VALUATION) 2.90 <br /> NORTHERN'S ONE HOUR MAIL-[N FEE 2.00 <br /> 9431 ALPINE DRIVE <br /> RAMSEY, MN 55303- TOTAL 77.40 <br /> (763)323-7597 Payment(s) <br /> Minnesota State License#: BUIL-MB003479 CREDIT CARD 4674 77.40 <br /> OWNER <br /> TRUBECK, WILLIAM &JUDITH <br /> 3300 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 Buildin�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 /> cxpire 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 AO days at any time afrer 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 for due cause. <br /> i . <br /> � ! i L ��� C_�� �� _ / < < /` �- , � � % �i � i' <br /> � � <br /> Applicant Permitec Signature ' Date Issued By Signature Date <br />