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� CITY OF ORONO * z 0 1 7 - 0 0 6 1 � <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/07/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3188 NORTH SHORE DR <br /> PIN : 09-117-23-32-0011 <br /> LEGAL DESC : CRYSTAL BAY PARK <br /> : LOT 000 BLOCK 004 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,975.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> NEW HEATING SYSTEM <br /> GAS L[NE FOR POOL HEAT'ER&OUTDOOR FIREPIT <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.49 <br /> METRO GAS INSTALLERS TOTAL 51.49 <br /> 685 141ST LANE NW <br /> ANDOVER, MN 55304 Payment(s) <br /> CHECK 16684 51.49 <br /> (763)754-7119 <br /> Minnesota State License#: mech-MB003162 <br /> OWNER <br /> RUCINSKI,MICHEAL&HOLLY <br /> 3188 NORTH SHORE DR <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 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 /> expirc and become null and void if construction authorized is not <br /> commenced within I RO 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 wit the State Buildin de.This permit may be <br /> revoked at any time for due use. /�,r <br /> ✓ �� � j -�. /�':� <br /> � � � �/ � <br /> Y- �'c�-:�l /,�--�,�°/��c, (�C i �� i / � <br /> Applica Permitee Signature Date Issued By Signature Date <br />