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CITY OF ORONO PERMIT NO.: 2009-00127 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 03/30/2009 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4545 WATERTOWN RD <br /> PIN : 31-118-23-24-0004 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 500.00 <br /> NOTE: <br /> GASLINE ONLY TO NEW FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> CENTRAIRE HEATING&AIR STATE SURCHARGE MECH(VALUATION) 0.50 <br /> 7402 WASHINGTON AVE <br /> EDEN PRAIRIE,MN 55344 TOTAL 50.50 <br /> (612)941-1044 PAID WITH CC# 5794 <br /> Minnesota State License#: 00TR93 <br /> OWNER <br /> BROLL,MR&MRS JEFF <br /> 4545 WATERTOWN RD <br /> MAPLE PLAIN, MN 55359 <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 i ,onsible for assuring all required inspections are <br /> requested i onf• a. •wit e State Building Code.This permit may be <br /> revoked; ime '• e ause. <br /> t/ / / 3/ 30 �� o o <br /> App icant Permite Signat e Date Is /PIA a � / te 1 <br /> Issue d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />