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, • CITY OF ORONO * 2 0 1 5 - 0 1 4 9 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1 U20/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 2490 CARMAN ST <br /> PIN : 20-117-23-12-0065 <br /> LEGAL DESC : LEHMAN LAGOON <br /> : LOT 2 BLOCK 1 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS L[NE ONLY <br /> VALUATION : $ 1,750.00 <br /> NOTE: GASLINE TO OUTDOOR FIREPLACE <br /> APPLICANT MECHAN[CAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.88 <br /> METRO GAS INSTALLERS TOTAL 50.88 <br /> 685 141ST LANE NW Payment(s) <br /> ANDOVER, MN 55304 CHECK 15793 50.88 <br /> (763)754-71 l9 <br /> Minnesota State License#: mech-MB003162 <br /> OWNER <br /> Lakeshore Holdings LLC <br /> 153 E LAKE ST <br /> WAYZATA, MN 55391- <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[his type of work <br /> shall be compied with whether or not specified herein.This permit will _�-��C <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 is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �, <br /> / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br />