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� <br /> CITY OF ORONO * z 0 1 7 - 0 0 1 6 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/2U2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2995 DEER RUN TR <br /> PIN : 04-117-23-23-0030 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 000 BLOCK 000 <br /> PERM[T TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIV TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 9,100.00 <br /> NOTF,: ALL TESTING REPORTS SIiALL BE ON SITE AT FINAL INSPECTION. <br /> (1)DAIKIN FURNACE AND(I)DAIKIN A/C <br /> APPLICANT MECHANICAL 113.75 <br /> STATE SURCHARGE MECH(VALUATION) 4.55 <br /> CENTERPOINT ENERGY MAIL-IN FEE 2.00 <br /> 6161 GOLDEN VALLEY RD <br /> BUILDING A TOTAL 120.30 <br /> GOLDEN VALLEY,MN 55422- Payment(s) <br /> (763)512-2765 CHECK 20839 120.30 <br /> Minnesota State License#: mech-MB003503 <br /> OWNER <br /> LEISCHOW, KELLY <br /> 2995 DEER RUN TR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AIYD SWORIY 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 type of work <br /> shall bc compied with whether or not specified herein.This permit will <br /> expirc and become null and void if construction authorized is not <br /> commenced within l80 days of the date of issuance,or if construction is <br /> suspended for a period oY l80 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 /> c�����) _ �" ��/] <br /> Applicant Permitee Signa e Date Issued Signature Date <br />