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� ~ CITY OF ORONO <br /> * Z 0 1 2 — 0 1 1 5 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/13/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 519 FERNDALE RD N <br /> PIN : 36-118-23-14-0008 <br /> LEGAL DESC : UNPLATTED 36 l]8 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 900.00 <br /> NOTE: GASI,INE FOR TWO FIREPLACES <br /> APPLICANT <br /> BOE PLUMBING MECHANICAL 50.00 <br /> 15481 KIOWA ST. STATE SURCHARGE MECH(VALUATION) 0.45 <br /> ANDOVER, MN 55304 TOTAL 50.45 <br /> (763)757-1991 <br /> Minnesota State License#: MB3984 <br /> OWNER <br /> MICHELETTI, TOM <br /> 519 FERNDALE RD N <br /> WAYZATA, MN 55391 <br /> AGREEMENT AIYD SWORIV 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 pennit 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 w�ork <br /> shall be compied with whether or not specitied herein.This perniit 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 /> I'he applicant is r sponsible for assuring all required inspections are <br /> requested in con rmanee with the State Building Code.This permit may bc <br /> revoked at any e for d cause. <br /> � <br /> / <br /> f � � j/� ,/ �� � <br /> Applicant 'ermitee Signature Date "" ' '—`���� �� ���� � <br /> [ssu E3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />