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CITY OF ORONO 111111111111111311111111111111111111 2750 KELLEY PARKWAY DATE ISSUED: 01/18/2018 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 4160 FOREST LAKE DR PIN : 07-117-23-11-0003 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 004 BLOCK 001 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : MECHANICAL-MULTIPLE VALUATION : $ 4,000.00 NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. (1)KITCHEN EXHAUST-6"DUCT-300 CFM (3)BATH EXHAUST-50 CFM GASLINE FOR FUTURE FIREPLACE APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 2.00 LEGEND SERVICES, INC P O BOX 382 TOTAL 52.00 LORETTO,MN 55357- Payment(s) (763)479-5002 CHECK 8351 52.00 Minnesota State License#:plbg-PC644501,mech-MB005090 OWNER CLINE,JUSTIN&HOLLY 4160 FOREST LAKE DR MOUND,MN 55364- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. f� Applicantite Signature / IDate Issued B ignature Date /15—V05/—.