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` �� CITY OF ORONO * 2 0 1 z - 0 1 z z s * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/06/2012 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2900 DEER RUN TR <br /> PIN : 04-117-23-24-0013 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 008 BLOCK 004 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY . <br /> VALUATION : $ 1,300.00 <br /> NOTE: GAS LINE TO POOL HEATER 250,000 BTU <br /> APPLICANT MECHANICAL 50.00 <br /> METRO GAS INSTALLERS STATE SURCHARGE MECH(VALUATION) 0.65 <br /> 685 141ST LANE NW TOTAL 50.65 <br /> ANDOVER,MN 55304 <br /> (763)754-7119 <br /> OWNER <br /> KACZKE,ROBERT&JILL <br /> 2900 DEER RUN TR <br /> LONG LAKE,MN 55356- <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 consWction 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 uilding Code.This permit may be <br /> revoked at any t' f due cause. <br /> �J / / � <br /> Applic ermitee Signatu Date Issued By S' ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABOV . <br />