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CITY OF ORONO � <br /> ' � 2750 KELLEY PARKWAY * D 0E ISSUED: 06/6/0 6 * <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2195 FRENCH LAKE RD <br /> PIN : 10-117-23-21-0006 <br /> LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> ACTIVITY . <br /> VALUATION : $ 325.00 <br /> NOTE: 1 GAS L1NE,KITCHEN COOKTOP <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.16 <br /> WELD& SONS PLUMBING CO INC. MAIL-IN FEE 2.00 <br /> 3410 KILMER LANE N <br /> PLYMOUTH,MN 55441- TOTAL 5216 <br /> (763)475-0296 Payment(s) <br /> Minnesota State License#:plbg-PC646375,mech-MB003315 CREDIT CARD 6763 52.16 <br /> OWNER <br /> DALTON,MICHAEL&JENNIFER <br /> 2195 FRENCH LAKE 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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ��r ' C,-__--' � � j``��_,5;_x i � �o r� <br /> -���- �� � �- �� , , <br /> Applicant Permitee Signature Date Issued By Signature Date <br />