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CITY OF ORONO 1 1 1 1 1 ,11, 1 1 1 1 1 1 1 1 111 <br /> * 2018 - 00058 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/18/2018 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 776 BROWN RD N <br /> PIN : 34-118-23-11-0001 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1275 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,041.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> (1)CARRIER NATURAL GAS FURNACE <br /> APPLICANT MECHANICAL 50.51 <br /> FLARE HEATING&AIR COND STATE SURCHARGE MECH(VALUATION) 2.02 <br /> 9309 PLYMOUTH AVE N MAIL-IN FEE 2.00 <br /> SUITE 104 TOTAL 54.53 <br /> GOLDEN VALLEY,MN 55427 Payment(s) <br /> (763)542-1166 CREDIT CARD 0941 54.53 <br /> Minnesota State License#:mech-MB005424 <br /> OWNER <br /> BARBARA LUIKENS,RICHARD BENSON/ <br /> 776 BROWN RD N <br /> LONG LAKE,MN 55356- <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 /> 61/eUie-69 / f FI 122 <br /> Applicant Permitee Signature Date Issued By*nature Date <br />