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CITY OF ORONO * Z 0 1 5 - 0 P1 5 9 B * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/14/2015 <br /> � � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 761 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0092 <br /> LEGAL DESC : STONEBAY SEVENTH ADDITION <br /> : LOT 5 BLOCK 1 <br /> PERM�T TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 1,200.00 <br /> NOTE: GASLINE FOR(2)FIREPLACES,(1)RANGE AND(1)DRYER <br /> APPLICANT MECHANICAL 50.00 <br /> SCHULTIES PLUMBING STATE SURCHARGE MECH(VALUATION) 0.60 <br /> 1521 94TH LANE NE <br /> TOTAL 50.60 <br /> BLAINE, MN 55449 Payment(s) <br /> (65l)786-4007 CHECK 33282 50.60 <br /> Minnesota State License#:plbg-058799PM,mech-MB005379 <br /> OWNER <br /> Stonebrook Development LLC <br /> 1'7149 LINCOLN ST NE <br /> #600 <br /> HAM LAKE,MN 55304- <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�i�ill <br /> expire and become null and void if construc[ion 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 afier 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 anv time for due cause. <br /> �. � s - � <br /> �i -�s � , ��, i.s <br /> Applicant Permitee Signature Date Issued y Signature Date <br />