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II 1 I II 1111 11111111111,1 II <br /> CITY OF ORONO * 2 0 1 4 — 0 1 1 2 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/02/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 200 WAYZATA BLVD W <br /> PIN : 36-118-23-43-0001 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 110,000.00 <br /> NOTE: (2)HYDRO THERM NATURAL GAS HEATING SYSTEMS-5"FLUE-600,000 BTU INPUT,556,000 BTU OUTPUT <br /> APPLICANT MECHANICAL 1,375.00 <br /> JOHNSON CONTROLS STATE SURCHARGE MECH(VALUATION) 55.00 <br /> 2605 FERNBROOK LN MAIL IN FEE 2.00 <br /> PLYMOUTH, MN 55447 TOTAL 1,432.00 <br /> (763)585-5093 Payment(s) <br /> CREDIT CARD 7618 1,432.00 <br /> OWNER <br /> Wayzata Country Club <br /> 200 WAYZATA BLVD W <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 /> (iii <br /> natu <br /> /4I 1/ <br /> Applicant Permitee SigDate Issufi By Signature Date <br />