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. � <br /> CITY OF ORONO * 2 0 1 7 - 0 0 9 7 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/16/2017 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2455 SHADYWOOD RD <br /> PIIY : 20-117-23-11-0017 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 002 BLOCK 004 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�T TYPE : COOLING SYSTEMS <br /> VALUATION : $ 5,352.00 <br /> NOTE: (1)LENNOX 5 TON A/C <br /> APPLICANT MECHANICAL 66.89 <br /> STATE SURCHARGE MECH(VALUATION) 2.68 <br /> SEDGWICK HEATING&A/C MAIL-IN FEE 2.00 <br /> 1408 NORTHLAND DR-SUITE 310 <br /> MENDOTA HEIGHTS,MN 55120- TOTAL 71.57 <br /> (952)881-9000 Payment(s) <br /> CHECK 17810 71.57 <br /> OWNER <br /> ENGLUND, PAUL&JEANNE <br /> P.O. BOX 95 <br /> NAVARRE,MN 55392- <br /> AGREEMENT AND SWORN STATEMEIYT <br /> The work for which this permit is issued shall be performed according to <br /> [he 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 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 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 afrer 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 /> L����� l�o � �sv � �� �e� � <br /> Applicant Permitee Signature Date Issued By ignature Date <br />