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1 ' <br /> CITY OF ORONO PERMIT NO.: 201Q00844 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 09/15/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1435 PARK DR <br /> PIN : 07-117-23-42-0020 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK O15 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 1,500.00 <br /> NOTE: GASLINE TO A FIRE PIT AND OUTDOOR GRILL <br /> APPLICANT <br /> MECHANICAL 50.00 <br /> METRO GAS INSTALLERS STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 685 141ST LANE NW TOTAL 55.00 <br /> ANDOVER,MN 55304 <br /> (763)7547119 <br /> OWNER <br /> CAMERON,JENNIFER&DAVID <br /> 1435 PARK 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 sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become nuil 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 confo ance with the Stat Building Code.This permit may be <br /> revoked a ti for ue ca e. <br /> � ' � i/S l/D <br /> plicant Permitee Signature Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />