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CITY OF ORONO * z � 1 4 -� 5�4 � <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 12/22/2014 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2780 SHADYWOOD RD <br /> PIN : 21-117-23-24-0041 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1 196 <br /> : LOT 000 BLOCK 000 <br /> PERM[T TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 4,378.00 <br /> NOTE: BRANDT HI:A"I'1NG SYSTEM <br /> APPLICANT MECHANICAL 54.73 <br /> STATE SURCHARGE MECH (VALUATION) 2.19 <br /> STANDARD HEATING& AIR CONDITIONING MAIL-IN FEE 2.00 <br /> 130 PLYMOUTH AVENUE N. <br /> MINNEAPOLIS, MN 55411- TOTAL 58.92 <br /> 612-824-2656 Payment(s) <br /> CHECK 47754 58.92 <br /> OWNER <br /> CARTER, RICHARD& JEANNE <br /> 2780 SHADYWOOD RD <br /> EXCELSIOR, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> "fhe work for which this permit is issued shall be perfomied 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 separatc <br /> pemiits. 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 180 days at any time alter work has commenced. <br /> 1'he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the S[ate Building Code.This permit may be <br /> revoked at any time for due cause. �J,� <br /> t�! <br /> / � l�� I � c� f �_,��� � � c������ � iz , z �, �c� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />