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� � CITY OF ORONO * Z 0 1 5 — 0 1 3 0 0 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 10/07/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADD SS : 3050 SUSSEX RD <br /> PIN : 04-117-23-32-0010 <br /> LEG �D C : FOX BEND <br /> : LOT 004 BLOCK 001 <br /> PER �T PE : MECHANICAL(>$500) <br /> PR �R TYPE : RESIDENTIAL <br /> CO S'I'R TION TYPE : GAS LINE ONLY <br /> VA II�AT N : $ 1,000.00 <br /> NO :; G LINE TO GENERATOR THROUGH SOFFITS <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.50 <br /> P �CT AL SYSTEMS MAIL-IN FEE 2.00 <br /> 4 4�B DY OAK RD <br /> �K S,MN 55343 TOTAL 52.50 <br /> ( 52)9 1868 Payment(s) <br /> CREDIT CARD 3543 52.50 <br /> OWNER <br /> AKER,RONALD&SUSAN <br /> 0�0 SSEX RD <br /> C1N AKE,MN 55356- <br /> � EMENT AND SWORN STATEMENT <br /> GRE <br /> hall be erformed accordin to <br /> 'f�e w k for which this permit is issued s p g <br /> tl�e ap oved plans and specifications,applicable City approvals,and the <br /> State ilding Code. This pertnit is for only the work described and dces <br /> npt g t permission for additional or related work which requires separate <br /> qermi All provisions of laws and ordinances governing this rype of work <br /> s�all compied with whether or not specified herein.This permit will <br /> e�xpir d become null and void if construction authorized is not <br /> �om nced within 180 days of the date of issuance,or if construction is <br /> �us ed for a period of I80 days at any time after work has commenced. <br /> he licant is responsible for assuring all required inspections are <br /> tequ ed in conformance with the State Building Code.This permit may be <br /> �evo at any time for due cause. � <br /> � /v � 7 ,�.� <br /> iAp cant Permitee Si ture Date Is ued y Signature Date <br /> I <br />