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CITY OF ORONO PERMIT NO.: 2011-01309 <br /> 2750 KELLEY PARKWAY <br /> r <br /> � ORONO, MN 55356- �ATE ISSUEu: 10/24/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3510 BAYSIDE RD <br /> PIN : OS-117-23-13-0016 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL- MULTIPLE <br /> VALUATION : $ 625.00 <br /> NOTE: 1 HEATING SYSTEM <br /> I GAS LINE TO POOL HEATER <br /> APPLICANT MECHANICAL 50.00 <br /> METRO GAS INSTALLERS STATE SURCHARGE MECH (VALUATION) 0.31 <br /> 685 141ST LANE NW <br /> ANDOVER, MN 55304 TOTAL 50.31 <br /> (763)754-7119 <br /> OWNER <br /> LARSEN, GREGG & STEPHANIE <br /> 3510 BAYSIDE RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> nc�work for which this permit is issued shall be performed according to <br /> thc approved plans and specitica[ions,applicable City approvals,and the <br /> State Building Code. This permit is for only the work dcscribed and docs <br /> not grant pennission 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 specificd herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I 80 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 /> "rhe applicant is responsible for assuring all required inspections are <br /> requested in confor nce rth[he State Buildi de.This permit may be <br /> revoked at any for e ca ' <br /> � � � � � .��' / / / / <br /> Appl' ant Permitee Signature � Date Issued By ' n ture ate _, <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRtBED AB E. <br />