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CITY OF ORONO Ik 1�2 I I ll- 0 I I I e lI' <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/16/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4009 NORTH SHORE DR <br /> PIN : 07-117-23-44-0004 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 2,500.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> INSTALL UNIT HEATER-MODINE NATURAL GAS-4"FLUE <br /> FLUE AND GASLINE ARE ALREADY ROUGHED IN <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.25 <br /> 2-GUYS PLUMBING&HEATING INC TOTAL 51.25 <br /> P.O.BOX 573 <br /> Payment(s) <br /> HOWARD LAKE,MN 55349- CHECK 001928 51.25 <br /> (320)543-2400 <br /> Minnesota State License#: HVAC-MB003305 <br /> OWNER <br /> SPLINTER,JAMES&VICKI <br /> 4009 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 laws 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 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 /> • /I'/ -17 4sori ertso II /cp' /7 <br /> Applicant Permi ignature Date Issued Signature Date <br />