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`� ' CITY OF ORONO PERMIT NO.: 2009-00670 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEu: 10/OS/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1980 SIXTH AVE N <br /> PIN : 27-118-23-42-0004 <br /> LEGAL DESC : UNPLATTED 27 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 912.00 <br /> NOTE: <br /> ADDING(1)RETURN IN BASEMENT,NEW DRYER VENT AND RELOCATE(2)SUPPLIES <br /> APPLICANT MECHANICAL 50.00 <br /> DITTER INC. STATE SURCHARGE MECH(VALUATION) 0.50 <br /> 820 TOWER DRIVE <br /> MEDINA,MN 55340 TOTAL 50.50 <br /> (763)478-9558 <br /> OWNER <br /> PIERPONT,JUDY <br /> 1801 WEST FARM RD <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 goveming 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 wi[h the State Building Code.This permit may be <br /> revoke ny time for due cause. <br /> � �.Q7�Gv= iC � S �c5 / l <br /> Applicant Permitee Signatur Date I d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />