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CITY OF ORONO PERMIT NO.: 2011-00656 <br /> � 2750 KELLEY PARKWAY <br /> > ORONO,MN 55356- DATE ISSUED: 07/14/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1720 SHADYWOOD RD <br /> PIN : 17-117-23-21-0019 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : VENTILATION <br /> NOTE: MOVING ONE TOE KICK <br /> 1 KITCHEN EXHAUST <br /> VENTING MICROHOOD <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> METRO AIR INC. STATE SURCHARGE MECH(<$500) 0.50 <br /> 16980 WELCOME AVE SE <br /> PRIOR LAKE,MN 55372 MAIL-IN FEE 2.00 <br /> (952)447-8124 MISC FEE 4.50 <br /> TOTAL 22.00 <br /> OWNER <br /> MONSON,TOM&ANN � <br /> 225 COUNTRY CLUB COURT <br /> LACROSSE,WI 54601- <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 Ciry 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 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 wittththe State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ��Z�(� �(, / / / / <br /> Applicant Permitee Signature Date Issued By gnature e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />