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CITY OF ORONO * Z 0 1 2 - 0 1 Z 6 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/20/2012 <br /> ` � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1250 BRIAR ST <br /> PIIV : 10-117-23-31-0039 <br /> LEGAL DESC : CRYSTAL BAY M[NNETONKA <br /> : LOT 000 BLOCK 002 <br /> PERMIT TYPE : MECHAN[CAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> NOTE: [NSTALL GAS STOVE, RUN GAS LINE,REPLACE COPPER,FLGX LINE AND ANTI-TIP 13RACKET <br /> APPWCANT MECHAN[CAL(<$500) 15.00 <br /> CENTER POINT ENERGY MINNEGASCO STATE SURCHARGE MECH (<$500) 5.00 <br /> 9320 EVERGREEN BLVD NW <br /> SU[TE B MAIL-IN FEE 2.00 <br /> COON RAPIDS, MN 55433 MISC FEE 0.00 <br /> ��6���s�-62o2 TOTAL 22.00 <br /> OWNER <br /> PEARSON, LAURIE <br /> 1250 BRIAR ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORIV STATEMENT <br /> The work for which this permit is issucd shall be performcd according to <br /> thc approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work describcd and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this typc 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 /> reques[ed in conformance with�he State Building Codc.This permit may be <br /> revoked at any time for due cause. <br /> i�%�Q-� � � � � � <br /> Applicant Permitee Signature Date Issued By gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED OVE. <br />