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, <br /> , CITY OF ORONO * Z 0 1 4 - 0 1 2 4 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/27/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> AllDRESS : 128 CHEVY CHASE DR <br /> PIIV : 36-118-23-41-0041 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 007 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 2,155.00 <br /> NOTF,: I BATH FAN.4 RETL?RNS TO LL <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 1.08 <br /> PRONTO HEATING&AC MAIL-IN FEE 2.00 <br /> 7588 WASHINGTON AVE S <br /> EDEN PRAIRIE, MN 55346- TOTAL 53.08 <br /> (952) 835-7777 Payment(s) <br /> CHECK 9611 53.08 <br /> OWNER <br /> NELSON,TODD&JANA <br /> l28 CHEVY CHASE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performcd according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Buiiding Code. This permit is for only the work described and does <br /> not grant pemiission 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 specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced wi[hin 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 /> �.L �-.-� �.�-dr��--� f� �-7 �� <br /> Applicant Permitee Signature Date Iss eu d By Signature Date <br />