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CITY OF ORONO PERMIT NO.: 2010-00415 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 06/01/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 835 WINDJAMMER LA <br /> PIN : 07-117-23-11-0008 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> NOTE: GAS LINE TO FIREPLACE <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> SCHULTIES PLUMBING STATE SURCHARGE MECH(<$500) 0.50 <br /> 1521 94TH LANE NE <br /> BLAINE,MN 55449 MAIL-IN FEE 2.00 <br /> (651)786-4007 MISC FEE 0.00 <br /> Minnesota State License#: 058799PM TOTAL 17.50 <br /> OWNER <br /> HANSON, SCOTT&JENNIFER <br /> 835 WINDJAMMER LA <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 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 nd become null and void if construction authorized is not <br /> com nced within 180 days of the date of issuance,or if construction is <br /> su ended for a period of 180 days at any time after work has commenced. <br /> T e applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> Irevoked at any time for due cause. <br /> 627ILL-s'e l l <br /> /Applicant Permitee Signature Date Issued 1 ignatureto <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABBO\(E) <br />