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� CITY OF ORONO PERMIT NO.: 2011-01090 <br /> 2750 KELLEY PARKWAY <br /> ' ORONO, MN 55356- DATE ISSUED: 09/20/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 930 COX FARM RD <br /> PIN : 27-118-23-33-0013 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT O10 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS L[NE ONLY <br /> VALUATION : $ 800.00 <br /> NO"I'L: GAS LINES TO(2)SEPARATE FIREPLACF.S <br /> APPLICANT <br /> MECHAN[CAL 50.00 <br /> NRH PLUMBING INC. <br /> 6460 153RD LN STATE SURCHARGE MECH(VALUATION) 0.40 <br /> RAMSEY, MN 55303- TOTAL 50.40 <br /> (612)245-7280 <br /> Minnesota State License#: 067436 PM <br /> OWNER <br /> KILLINGSTAD, MR.& MRS. <br /> 930 COX FARM RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permit is issued shall bc performcd according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State[3uilding Code. This permit is tor only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> pennits. All provisions of laws and ordinances governing this type of work <br /> shali be compied wilh whether or not specified herein.This permit will <br /> expire and become null and void if construetion authorized is not <br /> commenced wi[hin 180 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days a[any[ime atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in nfonnance ith[ State[3uilding Code.This permit may be <br /> revoked at an time for d ca s � <br /> l / ZU / � � / / <br /> Applicant Permitee Si a re Date Issue 13y nature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED AB . <br />