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CITY OF ORONO * z 0 1 6 - 0 0 0 0 7 * <br /> 2750 KELLEY PARKWAY DATE 1SSUED: OU05/2016 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: 952 249-4616 <br /> ADDRF.SS : 3115 SUSSEX RD <br /> PIN : 04-117-23-32-0015 <br /> LEGAL DESC : FOX BEND <br /> : LOT 004 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYP : RESIDENTIAL <br /> C01�ISTRUCTION TYP� : HEATING SYSTEMS <br /> VALUATION : $ 2,000.00 <br /> NOTE: REPLACE H ATIN�G SYSTEM(TRANE) <br /> AP LICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.00 <br /> PRACTICAL SYST MS MAIL-IN FEE 2.00 <br /> 4342B SHADY OA RD <br /> HOPKINS, MN 553 3 TOTAL 53.00 <br /> (952)933-1868 Payment(s) <br /> CREDIT CARD 3543 53.00 <br /> I WNER <br /> MARY RASKOB, ANIQ.DELMORE& <br /> 3115 SUSSEX RD <br /> LONG LAKE, MN 5356- <br /> AGREEME AND SWORN STATEMENT <br /> The work for which this ermit is issued shall be performed according to <br /> the approved plans and s ecifications,applicable City approvals,and the <br /> State Building Code. Th s permR is for only the work described and does <br /> not grant permission for dditiorpl or related work which requires separate <br /> permits. All provisions laws�ordinances goveming this type of work <br /> shall be compied with w ether ot not specified herein.This permit will <br /> expire and become null d voidlifconstruction authorized is not <br /> commenced within 180 ys of the date of issuance,or if construction is <br /> suspended for a period o l80 days at any time after work has commenced. <br /> The applicant is responsi le for assuring all required inspections are <br /> requested in conformanc with the State Building Code.This permit may be <br /> revoked at any time for e causC. <br /> �1 � � rl f ;� 'y: �,`���i� ����c_.;�—��� I � ��� � I �' <br /> Applicant Permitee Si nature ate Issued�By Sigri'ature Date <br /> � <br /> I �i <br />