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�' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * � 0 1 7 - 0 0 6 5 6 * <br /> DATE ISSUED: 06/19/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2050 SHORELINE DR <br /> PIN : 10-117-23-34-0014 <br /> LEGAL DESC : HARTWOOD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> l0'GASLINE TO NEW PUMP STAT[ON GENERATOR <br /> APPLICANT <br /> R J MECHANICAL TOTAL <br /> P O BOX 373 Payment(s) <br /> MORA, MN 55051- <br /> (320)679-0602 <br /> Minnesota State License#:mech-M6004174 <br /> OWNER <br /> BERTA KVAMME TRUST(TOM BROSTROM) <br /> 2050 SHORELTNE DR <br /> WAYZATA, MN 55391- <br /> AGREEMEIYT AND SWORN STATEMENT <br /> "I�he 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 iY construction is <br /> suspended for a period of 1 SO 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. <br /> r7 <br /> '�` f '/ <br /> '� /��/ ��,� !'�-` � a —�2 �C; c�; l ��1/ � 7 <br /> � r, L� <br /> Applicant Permitee Signature Date �ssued Signature Date <br />