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� CITY OF ORONO * 2 0 1 5 - 0 1 3 1 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/12/2015 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1990 SHADYWOOD RD <br /> PIN : 17-117-23-24-0027 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 040 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 15,000.00 <br /> NOTE: ADDITIONAL: 1 �IEATING SYSTEM(RUUD), 1 COOLING SYSTEM(RUUD)AND 1 KITCHEN EXHAUST&3 BATH EXHAUSTS, <br /> 1 GAS LINE TO FURNACE <br /> APPLICANT MECHANICAL 187.50 <br /> STATE SURCHARGE MECH(VALUATION) 7.50 <br /> SAM HENDRICKSON PLBG&HEATING INC MpIL-IN FEE 2.00 <br /> 29901 725TH AVE TOTAL 197.00 <br /> DASSEL,MN 55325- <br /> Minnesota State License#:plbg-PC646230,mech-MB005006 Payment(s) <br /> CREDIT CARD 7507 197.00 <br /> OWNER <br /> VONFELDT&ELAINE WYATT,JEFF <br /> 1990 SHADYWOOD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pertnit is issued shall be perfonned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 'fhis 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 consWction authorized is not <br /> commenced within 1 SO 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 /> � ��-`�SO � Z <br /> � 1 ��-� �� �j � � I , <br /> Applicant Permitee Signature Date Issued By Signature Date <br />