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•� CITY OF ORONO * 2 0 1 6 - 0 1 1 3 6 * <br /> ,. 2750 KELLEY PARKWAY DATE ISSUED: 09/19/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3712 LIVINGSTON AVE <br /> PIN : 17-117-23-34-0059 <br /> LEGAL DESC : LAKE MINNETONKA WOODS <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 950.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> REPAIR/REPLACE DAMAGED MAIN GAS LINE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.48 <br /> PERFECTION HEATING&AIR MAIL-IN FEE 2.00 <br /> 1770 GERVAIS AVE <br /> MAPLEWOOD,MN 55109 TOTAL 52.48 <br /> (651)777-7620 Payment(s) <br /> Minnesota State License#:mech-MB003122 CREDIT CARD 2521 52.48 <br /> OWNER <br /> HALLOCK,TIFFINY <br /> 3712 LIVINGSTON AVE <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 dces <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 ISO 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. A �,n <br /> ���'�J <br /> - �C�c�.�e.�1 V��...� —f�c� �i /9 �� <br /> � CC 1 � c� �uf <br /> Applicant Permitee Signature Date Issued By Signature Date <br />