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�, CITY OF ORONO * 2 0 1 6 - 0 1 5 5 0 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 12/19/2016 <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 <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUAT[ON : $ 3,320.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECT[ON. <br /> BRYANT FURNACE REPLACEMENT <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MEC�-I(VALUATION) 1.66 <br /> ROL A[R PLUMBING&HEATING MA[L-[N FEE 2.00 <br /> 1 1792 272ND AVE N W <br /> ZIMMERMAN,MN 55398- TOTAL 53.66 <br /> (763)248-8909 Payment(s) <br /> Minnesota State License#:mech-MB676827 CHECK 2959 53.66 <br /> OWNER <br /> GARNETT, BRANDI <br /> 3400 FOX ST <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> i�he 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 addi[ional 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 1 SO days of the date of issuance,or if construetion 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 State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ,� �-�c�Sv /�-i / 5 i /b <br /> Applicant Permitee Signature � Date Issued Signature Date <br />