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, CITY OF ORONO * 2 0 1 2 - 0 0 5 5 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/19/2012 <br /> • • ORONO,MN 55356- <br /> (952 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1710 SHADYWOOD RD <br /> PIN : 17-117-23-21-0018 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMTT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 10,500.00 <br /> NOTE: 1 LENNOX GAS FURNACE <br /> 1 LENNOX 3 TON AC <br /> APPLICANT MECHANICAL 131.25 <br /> GOLDEN VALLEY HEATING&AIR STATE SURCHARGE MECH(VALUATION) 5.25 <br /> 5182 WEST BROADWAY <br /> CRYSTAL,MN 55429- MAIL-IN FEE 2.00 <br /> (612)535-2000 TOTAL 138.50 <br /> OWNER <br /> FITZPATRICK,JOHN&JOAN <br /> 1710 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 dces <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 aze <br /> requested in conforntance with the State Building Code.This permit may be <br /> revoked at any time for due causP. <br /> �y'.c'a-�.! �n" i i ���7�� l l <br /> Applicant Permitee Signature Date Issued By Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER N DESCRIBED AB E. <br />