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CITY OF ORONO * 2 0 1 2 - 0 0 4 4 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/13/2012 <br /> Z ORONO, MN 55356- <br /> i 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1100 MILLSTON RD <br /> PIN : 10-117-23-14-0015 <br /> LEGAL DESC : MILLSTON <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : FUEL STORAGE TANK <br /> VALUATION : $ 3,715.00 <br /> NOTE: OK'D BY:LYLE OMAN <br /> APPLICANT MECHANICAL 50.00 <br /> BURWELL, MR. & MRS. RODNEY P STATE SURCHARGE MECH (VALUATION) 1.86 <br /> 7901 XERXES AVE S TOTAL 51.86 <br /> BLOOMINGTON, MN 55431- <br /> PAID WITH CC# 2766 <br /> OWNER <br /> BURWELL, MR. &MRS. RODNEY P <br /> 7901 XERXES AVE S <br /> BLOOMINGTON, MN 55431- <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 gran[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 co ce with the State Building Code.This permit may be - <br /> revoked at afly f e for cause. -� ', ��✓' <br /> _�-. _ � <br /> � �' l` <br /> r / . � j , � ?_ ,��.,-�. { ` '_, i L�� � �= =r %" _ = <br /> � �Y �� %� �_ ._; <br /> Applicant Perm��' ature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />