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CITY OF ORONO PERMIT NO.: 2009-00919 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �SSUEn: 12/29/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 290 CRESTV[EW AVE <br /> PIN : OS-117-23-14-0018 <br /> LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> NOTE: ADD 2 HEAT SUPPLYS TO F,XISTING DUC"I'WORK <br /> FIREPLACE GAS LINE <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> C & M PLUMBING & HEATING STATE SURCHARGE MECH (<$500) 0.50 <br /> 610 CENTRAL AVENUE <br /> BUFFALO, MN 55313- TOTAL 15.50 <br /> PAID WITH CASH 15.50 <br /> OWNER <br /> HOCHSTEDLER, SCOTT <br /> 290 CRESTVIEW AVE <br /> LONG LAKE, MN 55356- <br /> ACREEMENT AIYD SWORN STATEMENT <br /> 'I�he work for which this pennit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> Sta[e Building Code. This pennit 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 pennit 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 construc[ion is <br /> suspendcd 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 tiipe for due cause. <br /> � y� ���� �`' � �% <br /> �y� c� <br /> � r.=" ;c"'�r � '% ':=':- i r / l l <br /> App ical nt Perruitee Sig�aCure Date Issued By Sig ure Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV <br />