2012 - 00153 - gas line only - Laserfiche WebLink

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CITY OF ORONO 2750 KELLEY PARKWAY ORONO, MN 55356- 249 -4600 FAX: (952) 249 -4616 ADDRESS 4550 WOLVERTON PL PIN 31- 118 -23 -31 -0005 LEGAL DESC FOXFYRE ESTATES LOT 001 BLOCK 001 PERMIT TYPE MECHANICAL (< $500) PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE GAS LINE ONLY NOTE: RUNNING GASLINE ONLY FOR FIREPLACE APPLICANT G -HVAC 16036 MALLARD WAY SE PRIOR LAKE, MN 55372- (612) 619 -9322 OWNER STEPHENSON, REVIS L 4550 WOLVERTON PL MAPLE PLAIN, MN 55359- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications, applicable City approvals, and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein. This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance, or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code. This permit may be revoked at any time for due cause. Applicant Permitee Signature Date * 2 0 1 2- 0 0 1 5 3* DATE ISSUED: 02/22/2012 MECHANICAL (< $500) 15.00 STATE SURCHARGE MECH (< $500) 5.00 TOTAL 20.00 PAID WITH CC # 9457 Issued By Signature Date 13i.r-rxr --i 1 F- r- LAk1v11 13 r'CyU1rxr,U rkJA W UMN U 1 HLK 1 HAIN UtS )UK-1t3t L) At3UV I✓.