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r <br /> 1 <br /> CITY OF ORONO PERMIT NO.: 2011-00049 <br /> t 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE IssUEn: OU24/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1801 LAKEVIEW TER <br /> PIN : 27-118-23-43-0004 <br /> LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN <br /> : LOT 005 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> � PROPERTY TYPE : RESIDENTIAL <br /> ' CONSTRUCTION TYPE : GAS LINE ONLY <br /> �: <br /> VALUATION : $ 0.00 <br /> NOTE: GAS LINE FOR GENERATOR <br /> � <br /> APPLICANT MECHANICAL 50.00 <br /> DEZIEL HVAC INC. STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 1612 3RD AVE.NE <br /> BUFFALO, MN 55313- MAIL-IN FEE 2.00 <br /> (612)719-1049 MISC FEE 0.00 <br /> TOTAL 57.00 <br /> OWNER <br /> FROMELL-THEIS,DENNIS THEIS&ANN <br /> 1801 LAKEVIEW TER <br /> LONG LAKE,MN 55356 <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 goveming this type of work <br /> - shall be compied with whether or not speci£ed 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time foF due cadse. <br /> `��� �—r� / / / / <br /> Applicant Permitee Signature Date Issued By Si ure Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />