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CITY OF ORONO * Z 0 1 6 — (d 1 2 7 PJ * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/OS/2016 <br /> , ORONO, MN 55356- <br /> f (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2024 SHADYWOOD RD <br /> PIN : 17-117-23-31-0011 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 004 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : VENTILATION <br /> VALUATION : $ 6,000.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECT[ON. <br /> VENTILATION: 1 KITCHEN EXHAUST,6 DUCT, 1 BATH EXHAUST <br /> GAS LINE FOR RANGE&FUTURE FIREPLACE 2ND FLOOR <br /> APPLICANT MECHANICAL 75.00 <br /> STATE SURCHARGE MECH(VALUATION) 3.00 <br /> DLT HEATING&COOLING LLC TOTAL 78.00 <br /> 283 MYRTLE DR S Payment(s) <br /> ANNANDALE,MN 55302- CHECK 5109 80.00 <br /> (952)221-5711 TOTAL PAID 80.00 <br /> Minnesota State License#:mech-MB004959 DUE -2.00 <br /> OWNER <br /> KIEFFER,JOHN&BENJAMIN <br /> 2024 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 Buiiding 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 goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become nuli 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 eause. ' �� ��� � � <br /> _ � �l l � C_C:�� C,�:� `` ��� � C�% <br /> , a-��- /� � � � <br /> plican Permitee Signature Date Issued By Signature Date <br />