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CITY OF ORONO PERMIT <br /> 27�0 Kelley Parkway - PO Box 66 Permit Number: Po�s2o <br /> Crystal Bay, Minnesota 55323 Permit Type: Me�hani�al Pe�cs <br /> (952) 249-4600 Date Issued: si2i�2oo4 <br /> SITE ADDRESS: 770 Dickey Lake Dr <br /> I.ong Lake,MN 55356 <br /> PID: 27-118-23-33-0010 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Permit Class: General <br /> Permit Type: Mechanical Permits Permit Sub-type(s): Gas Line Inspection <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate pernuts required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Pernut Fee: $ 15.00 <br /> Valuation: $ 0.00 <br /> State Surcharge Fee: $ 0.50 <br /> TOTAL FEE: $ 15.50 <br /> APPLICANT: Practical Systems OWNER: Charles&Jill Leukuma <br /> 4342B Shady Oak Rd. 770 Dickey Lake Dr <br /> Hopkins,MN 55343 Long Lake MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> i � � i�L ' L i � / � �Cc 6'� �(,�f'�J <br /> ' APPL CANT PERMITEE SIGNATURE ISSUED BY SIGNATURE <br /> Cooies: 1-File(SiQnitures Required), 1-Avplicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 <br />