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CITY OF ORONO III O III1ill MI I II 11 <br /> * 2014 - 01283 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/03/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 364 WESTLAKE ST <br /> PIN : 05-117-23-23-0043 <br /> LEGAL DESC : HILLSIDE PARK <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 275.00 <br /> NOTE: GAS LINE ONLY <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.14 <br /> SABRE HEATING&AIR COND INC. MAIL-IN FEE 2.00 <br /> 15535 MEDINA ROAD TOTAL 52.14 <br /> PLYMOUTH,MN 55447 <br /> (763)473-2267 Payment(s) <br /> ,‘'i:I %We 52.14 <br /> e <br /> OWNER <br /> Identisys, Inc. <br /> SHIELDS TRUSTEES,JANELLE K&MICHAEL R <br /> 7630 COMMERCE WAY <br /> EDEN PRAIRIE,MN 55344- <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 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. Le- <br /> issued <br /> rApplicant Permitee Signature Da c y Signature Dare <br />