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CITY OF ORONO I I1111111111111111111111111111111111111 <br /> * 20 1 6 - 0 1 032 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2016 <br /> ORONO,MN 55356- <br /> ' (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2. ORONO ORCHARD RD N <br /> PIN : 3.-118-23-33-0004 <br /> LEGAL DESC 'LATTED 35 118 23 <br /> : L I T 000 BLOCK 000 <br /> PERMIT TYPE ECHANICAL <br /> PROPERTY TYPE : 't SIDENTIAL <br /> CONSTRUCTION TYPE : r S LINE ONLY <br /> VALUATION : $ 1,050.00 <br /> NOTE: ALL TESTING REPORTS S i LL BE ON SITE AT FINAL INSPECTION. <br /> NEW GAS LINE FOR POOL HEATE'• <br /> APPLICANT MECHANICAL 50.00 <br /> METRO GAS INSTALLERS STATE SURCHARGE MECH(VALUATION) 0.53 <br /> 685 141ST LANE NW TOTAL 50.53 <br /> ANDOVER,MN 55304 Payments) <br /> (763)7547119 CHECK 16246 50.53 <br /> Minnesota State License#:mech-MB003162 <br /> OWNER <br /> BENEDICT,MICHAEL&DEBORAH <br /> 25 ORONO ORCHARD RD N <br /> LONG LAKE,MN 55356- <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 rgquired inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for cause. ,y' <br /> R, ?`ST.- tf <br /> Appli ant Permitee Signature Date Issued By Signature Date <br />