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CITY OF ORONO * z 0 1 5 - 0 0 8 3 0 * <br /> S 275� KELLEY PARKWAY DATE ISSUED: 06/29/2015 <br /> '` ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4064 NORTH SHORE DR <br /> PIIV : 07-117-23-44-0085 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 2,221.00 <br /> NOTE: REPLACE FURANCE-(1)BRYANT-NATURAL GAS-2"FLUE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.11 <br /> JANET M OBRIGEWITSCH, DAN H PHIPPS& <br /> 4064 NORTH SHORE DR TOTAL 51.11 <br /> MOUND, MN 55364- Payment(s) <br /> CHECK 304 51.11 <br /> OWNER <br /> JANET M OBRIGEWITSCH, DAN H PHIPPS& <br /> 4064 NORTH SHORE DR <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 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 authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conform�uee'wit1�the Sta[e Building Code.This permit may be <br /> revoked at any tim�for due cau�e. <br /> ? <br /> �' � -� � i�--�Zi l� <br /> Ap t Permitee Sign ture Date Is u y Signature Date <br />