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! � � CITY OF ORONO <br /> 2750 T�ELLEY PARKWAY * 2 0 1 7 - 0 0 5 5 2 * <br /> DATE ISSUED: 06/19/201'7 <br /> O�tONO, MN 55356- <br /> (952) 249-�600 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 <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : DUCT WORK <br /> VALUATION : $ 25,000.00 <br /> NOTE: DUCKTWORK AND BUILDOUT ON NW LOWER�,EVEL SUITES AND COMMON AREAS. <br /> APPLICANT ' MECHANICAL 312.50 <br /> STATE SURCHARGE MECH(VALUATION) 12.50 <br /> AIR QUALITY SERVICES IN. TOTAL 325.00 <br /> 7900 EXCELSIOR BLVD Payment(s) <br /> SUITE#750 � CREDIT CARD 7316 325.00 <br /> HOPKINS,MN 55343- <br /> (952)401-3838 <br /> Minnesota State License#:mech-MB003119 <br /> OW1�iER <br /> Ugorets 8098 LLC <br /> 410 11TH AVE S � <br /> HOPKINS,MN 55343- i <br /> AGREEMENT AND SWORN STATEMEN I <br /> The work for which this permit is issued shall be performed accordi g to <br /> the approved plans and specifications,applicable City approvals,an the <br /> State Buiiding Code. This permit is for only the work described an dces <br /> not grant permission for additional or related work which requires s parate <br /> permits. All provisions of laws and ordinances goveming this type f work <br /> shall be compied with whether or not specified herein.This permit ill <br /> expire and become nuil and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if constructi n is <br /> suspended for a period of 180 days at any time after work has com enced. <br /> The applicant is responsible for assuring all required inspections ar <br /> requested in conformance with the State Building Code.This perm may be <br /> revoked at any time for due cause. � <br /> -/°l �0 � � � lj / <br /> A p icant Permitee Signature Date Issued Signature Date <br /> � <br /> � <br />