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. CITY OF OiRONO PERMIT NO.: 2oov-0009� <br /> 2750 KELLEY P�,ARKWAY <br /> ORONO,M1V�55356- DATE ISSUED: 03/OS/2009 <br /> 952 249-4600 FAX: �� 952 249-4616 <br /> ADDRESS : 2500 SHADYWOOD RD <br /> PIN : 20-117-23-11-0034 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1630 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$S00) <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : COOLING SYSTEMS <br /> VALUATION : $ 4,500.00 <br /> NOTE: R&D CHILLER-JCY-SAL HA-208/230,3 TONS,5 H.POWER <br /> APPLICANT �C�N�� 56.25 <br /> CARGILL STATE SURCHARGE MECH(VALUATION) 2.25 <br /> 2500 SHADYWOOD ROAD <br /> EXCELSIOR,MN 55331 TOTAL 58.50 <br /> PAID�pVITH CASH 58.50 <br /> OWNER <br /> FOUNDATION,FRESHWATER <br /> 2500 SHADYWOOD ROAD <br /> C/O DONALD BRAUER <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfonned 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 dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming 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 confo ance with the State Building Code.This permit may be <br /> revoked at y ti or d e cause. <br /> 3 / � �a� � �a5� D9' <br /> App ant ermitee Signature Date Is d By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />