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' - CITY OF ORONO PERMIT NO.: 20�2-000ss <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: OU27/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3190 SUSSEX RD <br /> PIN : 04-117-23-32-0007 <br /> LEGAL D SC : FOX BEND <br /> : LOT 001 BLOCK 001 <br /> PERMIT PE : MECHANICAL(<$500) <br /> PROPERT TYPE : RESIDENTIAL <br /> CONSTR TION TYPE : GAS LINE ONLY <br /> NOTE: GA LINE FOR STOVE AND DRYER <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> NYBO-PE RSON CO.INC. STATE SURCHARGE MECH(<$500) 5.00 <br /> 6606 280T . STREET TOTAL 20.00 <br /> MN 5508& <br /> (952)461-2 49 PAID WITH CC# 2234 <br /> Minnesota ate License#:058650 <br /> OWNER <br /> KENNEY, OHN&MARY <br /> 3190 SUSS X RD <br /> LONG LA E,MN 55356- <br /> AGR EMENT AND SWORN STATEMENT <br /> The work for hich this permit is issued shall be performed according to <br /> the approved lans and specifications,applicable City approvals,and the <br /> State Buildin Code. This permit is for only the work described and dces <br /> not grant pe ission for additional or related work which requires sepazate <br /> permits. AII p ovisions of laws and ordinances goveming this type of work <br /> shall be comp d with whether or not specified herein.This permit will <br /> expire and be me null and void if construction authorized is not <br /> commenced thin 180 days of the date of issuance,or if construction is <br /> suspended for period of 180 days at any time after work has commenced. <br /> The applicant s responsible for assuring all required inspections are <br /> requested in c nformance with the State Building Code.This permit may be <br /> revoked at an time for due cause. <br /> � � � ,a� ,l a— <br /> A 'can P i ature Date Issued y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />