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CITY OF ORONO * 2 0 1 5 - 0 1 0 3 5 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/17/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 2494616 <br /> ADDRESS 4695 NORTH SHORE DR <br /> PIN 07-117-23-32-0059 <br /> LEGAL DESC TRISTANA COVE <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE MECHANICAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> NOTE: GASLINE FOR OUTDOOR GRILL AND COOKTOP <br /> APPLICANT MECHANICAL(<$500) 50.00 <br /> LEGEND SERVICES,INC STATE SURCHARGE MECH(<$500) 0.20 <br /> 201 N MEDINA ST TOTAL 50.20 <br /> P O BOX 382 Payment(s) <br /> LORETTO,MN 55357- CREDIT CARD 1282 50.20 <br /> (763)479-5002 <br /> Minnesota State License#:mech-MB005090 <br /> OWNER <br /> PORTER,CAMERON&MOLLY <br /> 4695 NORTH SHORE DR <br /> MOUND,MN 55364- <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 /> 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 /> cid-- UF / f711-5 <br /> Applicant P itee Signature Date �"' <br /> ySignature Date <br />