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t CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 17 - 01 <br /> 3 <br /> DAT0 E ISSUED: 10/11 7/22 017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1350 VINE PL <br /> PIN : 07-117-23-42-0030 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK 017 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,500.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> (1)DAIKIN NATURAL GAS HEATING SYSTEM <br /> APPLICANT MECHANICAL 50.00 <br /> CENTERPOINT ENERGY STATE SURCHARGE MECH(VALUATION) 1.25 <br /> 6161 GOLDEN VALLEY RD MAIL-IN FEE 2.00 <br /> BUILDING A TOTAL 53.25 <br /> GOLDEN VALLEY,MN 55422- Payment(s) <br /> (763)512-2765 CHECK 21252 53.25 <br /> Minnesota State License#:meth-MB003503 <br /> OWNER <br /> CHERBA,RICHARD <br /> 1340 VINE PL <br /> MOUND,MN 55364- <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 time for due cause. <br /> 61d,z jn'�d ) /0 / 17/ / 7. <br /> Applicant Pormitee Signature XDate Issued By&nature Date <br />