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CITY OF ORONO * 2 0 1 6 - 0 1 4 S 0 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 1U18/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 665 FERNDALE RD N <br /> PIN : 36-118-23-11-0003 <br /> LEGAL DESC : LINPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,600.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL[NSPECT[ON. <br /> REPLACE HEATING SYSTEM(BRYANT) <br /> APPLICANT MECHANICAL 57.50 <br /> STATE SURCHARGE MECH(VALUATION) 230 <br /> HEATING&COOLING TWO INC. MAIL-IN FEE 2.00 <br /> 18550 COUNTY ROAD 81 <br /> MAPLE GROVE,MN 55369- TOTAL 61.80 <br /> (763)428-3677 Payment(s) <br /> CREDIT CARD 4334 61.80 <br /> OWNER <br /> BASTIAENS, FRANCISCUS <br /> 665 FERNDALE RD N <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORIv 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 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 /> 1��%� ���� '� � s,� � <br /> I � i 1 (,� Lt_� �� ;,�.� �- �� ��� � c, � �� <br /> Applicant Permitee Signature � Date Issued By S gnature Date <br />