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CITY OF ORONO * Z 0 1 7 - 0 PJ 3 4 9 * <br /> `' 2750 KELLEY PARKWAY DATE ISSUED: 04/12/2017 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1480 SIXTH AVE N <br /> PIN : 26-118-23-32-0008 <br /> LEGAL DESC : DOUGLAS ESTATES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 550.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> NEW:GAS LINE ONLY FOR FIREPLACE <br /> APPLICAIVT MECHANICAL 50.00 <br /> BOE PLUMBING STATE SURCHARGE MECH(VALUATION) 0.28 <br /> 15481 KIOWA ST. TOTAL 50.28 <br /> ANDOVER,MN 55304 Payment(s) <br /> (763)757-1991 CHECK 4508 5028 <br /> Minnesota State License#:plbg-PC644079 <br /> OWNER <br /> GULBRANDSON, DAN&ERICKA <br /> 1480 SIXTH AVE N <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 specitications,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 Ihis 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 I80 days at any time after work has commenced. <br /> The applicant is resp nsible for assuring all required inspections are <br /> requested in confor ance with the State Building Code.This permit may be <br /> revoked at any time or ue cau . <br /> . �� , � _ <br /> :� ;: � �_r_,.�; / --��=�=�- , , , ' <br /> � <br /> Applicant Perm Signature ate [ssued[3y Signature Date <br />