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CITY OF ORONO II 21.11111 Is 1111'II 11' 1111 II <br /> • 0 - 00776 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/06/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 925 OLD LONG LAKE RD <br /> PIN : 35-118-23-41-0029 <br /> LEGAL DESC : N/A <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 3,745.00 <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.87 <br /> STANDARD HEATING&AIR CONDITIONING MAIL-IN FEE 2.00 <br /> 130 PLYMOUTH AVENUE N. <br /> MINNEAPOLIS,MN 55411- TOTAL 53.87 <br /> 612-824-2656 Payment(s) <br /> CHECK 51583 53.87 <br /> OWNER <br /> ANDERSON,KARIN <br /> 925 OLD LONG LAKE 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 time for due cause. <br /> l <br /> a' p. ov / / /(0 <br /> Applicant Permitee Signature Date Issued By Signature Date <br />