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CITY OF ORONO 1111 1 1 1 1 1 1 11 1 1 1 111111111111 <br /> * 20 1 5 - 00780 * <br /> e• 2750 KELLEY PARKWAY DATE ISSUED: 06/17/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4520 WEST BRANCH RD <br /> PIN : 06-117-23-34-0004 <br /> LEGAL DESC : UNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 10,000.00 <br /> NOTE: I HEATING SYSTEM& 1 COOLING SYSTEM <br /> APPLICANT MECHANICAL 125.00 <br /> TOTAL COMFORT STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 4000 WINNETKA AVE N MAIL-IN FEE 2.00 <br /> SUITE 10 TOTAL 132.00 <br /> NEW HOPE,MN 55427- Payment(s) <br /> O CHECK 2292 132.00 <br /> OWNER <br /> EASTMAN,MICHEAL&THERESA <br /> 4520 WEST BRANCH RD <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 /> rn0�1 ,kPa lsd (0 17 t c <br /> Applicant Permitee Signature Date Issued By tgnaturd Date <br />