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• � ~ CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 6 - PJ 1 3 6 9 * <br /> DATE ISSUED: 10/27/2016 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2166 SHADYWOOD RD <br /> PIN : 17-117-23-42-0011 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 12,500.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> (1)LUXAIRE NATURAL GAS FURNACE <br /> (1)LUXAIRE A/C <br /> (1)KITCHEN EXHAUST 600 CFM <br /> (1)BATH EXHAUST-50 CFM <br /> APPLICANT MECHANICAL 156.25 <br /> STATE SURCHARGE MECH(VALUATION) 6.25 <br /> AMERICAN AIR SUPPLY,INC. TOTAL 162.50 <br /> 11257 207TH AVE NW Payment(s) <br /> ELK RIVER,MN 55330 CREDIT CARD 7294 162.50 <br /> (612)282-7568 <br /> Minnesota State License#:mech-MB003497 <br /> OWNER <br /> LACROIX,STEPHEN&SUSAN <br /> 2166 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 dces <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of Iaws 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 suthorized is not <br /> commenced within 180 days of the date of issuance,or if consWction 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 /> P �� � � � Sv �� ��7� /,C� <br /> Applic ermitee Signature Date Issued By Si ture Date <br />