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i� . <br /> CITY OF ORONO * 2 0 1 4 - 0 0 7 1 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/09/2014 • <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2248 SHADYWOOD RD <br /> PIN : 17-117-23-43-0126 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 4,500.00 <br /> NOTE: (1)BOSCH GREENSTAR COMB.-NATURAL GAS-3"FLUE <br /> APPLICANT MECHANICAL 56.25 <br /> STATE SURCHARGE MECH(VALUATION) 2.25 <br /> WESTONKA MECHANICAL INC TOTAL 58.50 <br /> 6501 COiINTY RD 15 <br /> MOLJND,MN 55364 Payment(s) <br /> (952)472-4966 CHECK 34238 58.50 <br /> OWNER <br /> LAGERSTROM, ED <br /> 2248 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 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 conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> (��-�_�•'m�,,.,:,, ? 1� I � � 7 � � �/5� <br /> "�Applicant rmitee Signature Date Issued y Signature Date <br />