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� <br /> .� <br /> CITY OF ORONO PERMIT NO.: 2011-00380 <br /> � 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE IssuEn: OS/23/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 395 SUSSEX LA <br /> PIN : 04-117-23-24-0007 <br /> LEGAL DESC : FOX BEND <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> ' CONSTRUCTION TYPE : GAS LINE ONLY <br /> ; <br /> VALUATION : $ 1,000.00 <br /> NOTE: GAS LINE TO OUTDOOR BBQ <br /> � APPLICANT MECHANICAL 50.00 <br /> GRABOW PLUMBING,INC. STATE SURCHARGE MECH(VALUATION) 0.50 <br /> 8420 REDWOOD STREET <br /> COON RAPIDS,MN 55433 TOTAL 50.50 <br /> �) <br /> Minnesota State License#: 038623PM <br /> OWNER <br /> CAMPBELL,JON&SUSAN <br /> 395 SUSSEX LA <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 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> d���Gc/��-�- r— � l � l << l l <br /> Applicant Permitee Signature Date Issued By Si ture ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO E. <br />