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. CITY OF ORONO * z 0 1 5 - � 0 1 8 0 * <br /> . <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/1 U2015 <br /> • ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 945 FOREST ARMS LA <br /> PIN : 07-117-23-12-0019 <br /> LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN <br /> : LOT 000 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 11,065.00 <br /> NOTE: 1 HEATING SYSTEM, 1 COOLING SYSTEM, 1 KITCHEN EXHAUST,3 BATH EXHAUST <br /> 1 GAS LINE TO GARAGE <br /> APPLICANT MECHANICAL 13831 <br /> WEST METRO MECHANICAL STATE SURCHARGE MECH(VALUATION) 5.53 <br /> TOTAL 143.84 <br /> 220 FRANKLIN ST Payment(s) <br /> NORWOOD YOLJNG AMERICA, MN 55368- CREDIT CARD 8702 143.84 <br /> Minnesota State License#: mech-684939 <br /> OWNER <br /> IVERSEN TRUSTEE, ROSEMARY C <br /> 2835 CASCO PT 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 sepazate <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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. /��J� <br /> %' <br /> � �'Y�,�� 2 �/r � �5 <br /> Applicant Permitee Signature Date Issued Signature Date <br />