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t ' CITY OF ORONO * 2 0 1 5 - 0 1 5 9 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/23/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1461 NORTH ARM DR <br /> PIN : 07-117-23-44-0070 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 500.00 <br /> NOTE: NEW COPPER GAS LINE TO KITCHEN STOVE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.00 <br /> CENTER POINT ENERGY MINNEGASCO MAIL-IN FEE 2.00 <br /> 9320 EVERGREEN BLVD NW <br /> SUITE B TOTAL 53.00 <br /> COON RAPIDS,MN 55433 Payment(s) <br /> (763)757-6202 CHECK 20049 53.00 <br /> Minnesota State License#:mech-003503 <br /> OWNER <br /> KANASKIE&KATIE ROBERTS,MATTHEW <br /> 1461 NORTH ARM DR <br /> MOLJND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he 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 goveming[his 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 /> � I'�.`l�C� ����SC� �� /2`�/ (S <br /> Applicant Permitee Si ture Date Issued By Signature Date <br />