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CITY OF ORONO 111111111111111111111111111111111 IN El IM <br /> * 2 0 1 6 — 0 1 5 2 4 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/12/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: 952)249-4616 <br /> ADDRESS : 1160 TONKAWA RD <br /> PIN : 08-117-23-13-0007 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.217 <br /> LOT 009 BLOCK 000 <br /> PERMIT TYPE MECHANICAL <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 750.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> GAS TO GENERATOR <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.38 <br /> PRACTICAL SYSTEMS MAIL-IN FEE 2.00 <br /> 4342B SHADY OAK RD TOTAL 52.38 <br /> HOPKINS,MN 55343 <br /> (952)933-1868 Payment(s) <br /> CREDIT CARD 5815 52.38 <br /> OWNER <br /> STANTON,MARSHALL S&MARLA K <br /> 1160 TONKAWA 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 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 /> LA? 124-1L <br /> Applicant Permitee Signature Date Issued B� ignature Date <br />