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� CITY OF ORONO * 2 0 1 4 - B 0 8 0 z * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 07/29/2014 <br /> ORONO,MN 55356- <br /> 952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4041 NORTH SHORE DR <br /> PIN : 07-117-23-44-0077 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1420 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 3,816.00 <br /> NOTE: 1 LENNOX 2 TON AC <br /> APPLICANT MECHANICAL 50.00 <br /> SEDGWICK HEATING&A/C STATE SURCHARGE MECH(VALUATION) 1.91 <br /> 1408 NORTHI.AND DR-SUITE 310 1VIAIL-IN FEE 9.23 <br /> MENDOTA HEIGHTS,MN 55118- TOTAL 61.14 <br /> (952)881-9000 Payment(s) <br /> CHECK 15112 53.91 <br /> CHECK 15112 7.23 <br /> OWNER <br /> MCCURDY,DALE <br /> 4041 NORTH SHORE DR <br /> MOi1ND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> T'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 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 conswction authorized 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ( <br /> / / <br /> Applicant Permitee Signature Date Issued By Si re � Date <br />