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111111111 <br /> CITY OF ORONO * 2 0 1 5 — 0 1 2 1 3 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/2 V2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 375 WAKEFIELD RD <br /> PIN : 36-118-23-31-0017 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE HEATING SYSTEMS <br /> VALUATION $ 9,595.00 <br /> NOTE: REPLACE STEAM BOILER LIKE FOR LIKE (WEIL MELAIN) <br /> APPLICANT MECHANICAL 119.94 <br /> STATE SURCHARGE MECH(VALUATION) 4.80 <br /> OWENS COMPANIES,INC. <br /> 930 EAST 80TH STREET MAIL-IN FEE 2.00 <br /> BLOOMINGTON,MN 55420- TOTAL 126.74 <br /> (952)854-3800 Payment(s) <br /> Minnesota State License#:mech-Mb003718 CHECK 11410 126.74 <br /> OWNER <br /> WARNER,DALE&ANN <br /> 375 WAKEFIELD 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 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 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 /> Applicant Permitee Signature Date Issued By Signature Date <br />