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CITY OF ORONO � � � � �� � � � 111111111E 11 <br /> * 2 0 1 8 — 0 0 0 2 1. * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/08/2018 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4740 BAYSIDE RD <br /> PIN : 31-118-23-33-0007 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,000.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> FURANCE CHANGEOUT-BRYANT <br /> APPLICANT MECHANICAL 50.00 <br /> SHC MECHANICAL INC. STATE SURCHARGE MECH(VALUATION) 1.00 <br /> 4728 BEDFORD ROAD TOTAL 51.00 <br /> MOUND,MN 55364- Payment(s) <br /> Minnesota State License#:mech-MB661890 CHECK 5931 51.00 <br /> OWNER <br /> IVERSEN,ROSEMARY C <br /> 2835 CASCO PT RD <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 tim or due cause. <br /> f Y 1 .11 / � �/g <br /> Applicant Irermitee Signature C Dat Issued By Sign.• Date <br />