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CITY OF ORONO III ' <br /> 2750 KELLEY PARKWAY * 21 8 - 0 0 4 9 * <br /> DATE ISSUED: 04/04/22 018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 500 ORONO ORCHARD RD S <br /> PIN : 02-117-23-31-0054 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT MB BLOCK 13 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 9,371.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> (1)CARRIER HEATING SYSTEM <br /> (1)CARRIER 2 TON A/C <br /> APPLICANT MECHANICAL 117.14 <br /> FLARE HEATING&AIR COND STATE SURCHARGE MECH(VALUATION) 4.69 <br /> 9309 PLYMOUTH AVE N MAIL-IN FEE 2.00 <br /> SUITE 104 TOTAL 123.83 <br /> GOLDEN VALLEY,MN 55427 Payment(s) <br /> (763)542-1166 CHECK 70604 123.83 <br /> Minnesota State License#:mech-MB005424 <br /> OWNER <br /> PETERSON,DONALD <br /> 500 ORONO ORCHARD RD S <br /> WAYZATA,MN 55391- <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 /> ( wth ).l � 4 , 4, 15 <br /> Applicant Permitee Signature Date Issue By Signature Date <br />