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CITY OF ORONO * Z 0 1 5 - PJ 1 5 1 5 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 12/02/2015 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 1629 BOHNS POINT RD <br /> PIN : 17-117-23-I1-0005 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0565 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS L[NE ONLY <br /> VALUATION : $ 2,000.00 <br /> NOTE: GAS LINE FOR RANGE&ROT[SSERIE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.00 <br /> MAJESTIC HEATING&AIR INC. TOTAL 51.00 <br /> 2030 BASSWOOD CT Payment(s) <br /> ROCKFORD,MN 55373- CREDIT CARD 0386 51.00 <br /> (612)227-5507 <br /> Minnesota State License#: mech-MB646225 <br /> OWNER <br /> AMPLATZ,CAROLINE <br /> 345 LEAF ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMEIVT <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 goveming 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 is responsible for assuring all required inspections are <br /> requested in conformance with the State B ng Code.This permit may be <br /> revoked at a e for due se � <br /> �� � � _ _ ` ��1? - <br /> L,����� � _��`�� �-�,i_ � � � ���_ <br /> Applicant P itee � ature Date [ssued By Signature Date <br /> /;. <br /> % <br />