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, = CITY OF ORONO * 2 0 1 6 - 0 1 4 9 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1 U30/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 3120 NORTH SHORE DR <br /> PIN : 09-117-23-32-0007 <br /> LEGAL DESC : CRYSTAL BAY PARK <br /> : LOT 000 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 6,900.00 <br /> NOTE: ALL TESTMG REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> TRINITY GAS BOILER <br /> APPLICANT MECHANICAL 86.25 <br /> STATE SURCHARGE MECH(VALUATION) 3.45 <br /> OWENS COMPANIES,INC. IVIpIL-IN FEE 2.00 <br /> 930 EAST 80TH STREET <br /> BLOOMINGTON,MN 55420- TOTAL 91.70 <br /> (952)854-3800 Payment(s) <br /> Minnesota State License#:mech-Mb003718 CREDIT CARD 7497 91.70 <br /> OWNER <br /> BORN,RICHARD <br /> 3120 NORTH SHORE DR <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMEIYT <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 dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of Iaws 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 suthorized 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 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 /> � ' t i�vi �� <br /> � <br /> Applicant Permitee Signature � Date Issued By S' ature Date <br />