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CITY OF ORONO * 2 0 1 5 - 0 0 1 5 0 * <br /> .'" 2750 KELLEY PARKWAY DATE ISSUED: 02/04/2015 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3225 SIXTH AVE N <br /> PIN : 29-118-23-44-0001 <br /> LEGAL DESC : LTNPLATTED 29 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTI01�1 TYPE : GAS LINE ONLY <br /> NOTE: GAS LINE TO NEW RANGE&KITCHEN EXHAUST <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> STATE SURCHARGE MECH(<$500) 5.00 <br /> BERKHOLDER,DREW&ATHENA MAIL-IN FEE 2.00 <br /> 3225 SIXTH AVE N <br /> LONG LAKE,MN 55356- TOTAL 22.00 <br /> Payment(s) <br /> CHECK No Numb 22.00 <br /> OWNER <br /> BERKHOLDER,DREW&ATHENA <br /> 3225 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 specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not gran[permission for additional or related work which requires sepazate <br /> permits. Al(provisions of laws and ordinances goveming 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � � � <br /> a,(, �: �.,�--�.-� GYyI G�r� _ � � � /_s. <br /> Applicant Permitee Signature Date Issued By ignature Date <br />