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CITY OF ORONO PERMIT NO.: 2010-00536 <br /> � 2750 KELLEY PARKWAY <br /> ~ ORONO,MN 55356- DATE ISSUED: 06/29/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2016 SHADYWOOD RD <br /> PIN : 17-117-23-31-0002 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 6,895.00 <br /> NOTE: 1 LENNOX 2.5 TON AC <br /> APPLICANT MECHANICAL 86.19 <br /> ABEL B&C INC. STATE SURCHARGE MECH(VALUATION) 3.45 <br /> 8750 HIGHWAY 7 <br /> PO BOX 97 MAIL-IN FEE 1.50 <br /> ST BONIFACIUS,MN 55375- MISC FEE 0.00 <br /> (952)446-9545 TOTAL 91.14 <br /> OWNER <br /> KOZICKY,MR.&MRS.RICHARD <br /> 2016 SHADYWOOD 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 I 80 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 canse. <br /> `�'�� (�41. / / / / <br /> Applicant Permitee Signature Date Issue y ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />