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CITY OF ORONO * Z 0 1 7 - 0 0 1 4 4 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 02/22/2017 <br /> * <br /> �. ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2500 SHADYWOOD RD <br /> PIIV : 20-117-23-11-0034 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1630 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : COMMERCIAL- BUSINESS <br /> CONSTRUCTION TYPE : DUCT WORK <br /> VALUATION : $ 12,000.00 <br /> NOTE: DUCT WORK FOR JOHN HENRY SUITE <br /> APPLICAI�TT MECHANICAL 150.00 <br /> STATE SURCHARGE MECH(VALUATION) 6.00 <br /> AIR QUALITY SERVICES [N. TOTAL 156.00 <br /> 7900 EXCELSIOR BLVD <br /> SUITE#750 Payment(s) <br /> HOPKINS,MN 55343- CREDIT CARD 7316 156.00 <br /> (952)401-3838 <br /> Minnesota State License#: mech-MB003119 <br /> OWNER <br /> Ugorets 8098 LLC <br /> 410 1 1TH AVE S <br /> HOPKINS, MN 55343- <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 1 SO 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 /> �(�J.�. <br /> /� <br /> �— <br /> _,�� � , <br /> /• ;, . � < '' � � � <br /> ��-��' �� /7 ��Q�t _.�;_ �fi ��� c,, � � <br /> � - � � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />