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CITY OF ORONO * Z 0 1 5 - 0 1 2 0 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/18/2015 <br /> < ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDi;ESS : 4108 H[GHWOOD RD <br /> PIN : 07-117-23-44-0089 <br /> LEGAL�'ESC : H[GHWOOD LAKE MTKA <br /> : LOT 040 BLOCK 000 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,538.00 <br /> NOTE: RF,PLACING HEATING SYSTEM(LENNOX) <br /> APPLICANT MECHANICAL 56J3 <br /> STATE SURCHARGE MECH(VALUATION) 2.27 <br /> DITTER COOL[NG& HEATING TOTAL 59.00 <br /> 820 TOWER DRIVE <br /> MEDINA, MN 55340 Payment(s) <br /> CREDIT CARD 1812 59.00 <br /> (763)478-9558 <br /> Minnesota State License#: mech-MB003161 <br /> OWNER <br /> Z[TZLSPERGER,CHELSIE <br /> 4108 HIGHWOOD RD <br /> MOUND, MN 55364- <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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 construc[ion au[horized is not <br /> commenced within l80 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 all required inspections are <br /> requested in conformance with the State Building Code.This permit may be I <br /> revoked at any time for due cause. �f 1.�7 <br /> � <br /> / � <br /> �' ^�,�.. ����`61 �� �C ;1 �'��..�:-�� � c � lk , � <br /> Applicant Permitee Si a re Date Issued By Signature Date <br />