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� CITY OF ORONO * 2 0 1 2 - 0 0 9 3 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/06/2013 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3435 CRYSTAL BAY RD <br /> PIN : 17-117-23-43-0120 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LiNE ONLY <br /> VALUATION : $ 800.00 <br /> APPLICANT MECHANICAL 50.00 <br /> BENJAMIN FRANKLIN PLUMBING STATE SURCHARGE MECH(VALUATION) 0.40 <br /> 1424 3RD STREET N <br /> MINNEAPOLIS, MN 55411- TOTAL 50.40 <br /> (763)755-6468 <br /> OWNER <br /> BROWN, SCOTT <br /> 3435 CRYSTAL BAY RD <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 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 S[ate Building Code.This permit may be <br /> revoked at any time for�lue cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By ' nature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />