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CITY OF ORONO * Z 0 1 6 - 0 0 1 5 6 * <br /> , � 2750 KELLEY PARKWAY DATE ISSUED: 02/12/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1020 BROWN RD N <br /> PIN : 27-118-23-42-0019 <br /> LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS L[NE ONLY <br /> VALUATION : $ 1,000.00 <br /> NOTE: NEW GAS LINE FOR LOG INSTALLATION IN EXISTING FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.50 <br /> FRANCIS,EDWARD MAIL-IN FEE 2.00 <br /> 1020 BROWN RD N <br /> LONG LAKE,MN 55356- TOTAL 52.50 <br /> Payment(s) <br /> CHECK 228 52.50 <br /> OWNER <br /> FRANCIS, EDWARD <br /> 1020 BROWN RD N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according ro <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 atter 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. ��Y ) <br /> , <br /> ��' C���, ,C� -_ ,� "�-'C-,�i'� �,��..�.�L ��_ / � Z/ � �` <br /> �.- ;� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />