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� CITY OF ORONO * 2 ID 1 z - B i z 1 9 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 12/04/2012 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2990 SUSSEX RD <br /> PIN : 04-117-23-31-0020 <br /> LEGAL DESC : FOX BEND <br /> : LOT 3 BLOCK 4 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 600.00 <br /> NOTE: GAS LINE FOR POOL HEATER <br /> APPLICANT MECHANICAL SQ.00 <br /> HEATING&COOLING TWO INC. STATE SURCHARGE MECH(VALUATION) 030 <br /> 18550 COUNTY ROAD 81 <br /> MAPLE GROVE,MN 55369- MAIL-IN FEE 2.00 <br /> (763)428-3677 TOTAL 52.30 <br /> PAID WITH CC# 0540 <br /> OWNER <br /> KELLY,JUSTIN& SUSAN <br /> 2990 SUSSEX 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 sepazate <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 theState Building Code.This permit may be <br /> revoked at any time for d�e cause. <br /> �%�l�-�t� �_ i l l l <br /> Applicant Permitee Signature Date Issued By Si ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />