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CITY OF ORONO * 2 0 1 7 - 0 0 7 7 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/07/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1121 NORTH ARM DR <br /> PIN : 07-117-23-14-0063 <br /> LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 1,500.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> GASLINE TO OUTDOOR GRILL AND FIREPIT <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.75 <br /> WELD&SONS PLUMBING CO INC. MAIL-IN FEE 2.00 <br /> 3410 KILMER LANE N <br /> PLYMOUTH,MN 55441- TOTAL 52.75 <br /> (763)475-0296 Payment(s) <br /> Minnesota State License#:plbg-PM059322,mech-MB003315 CREDIT CARD 6763 52J5 <br /> OWNER <br /> HUISMAN,BRIAN&ANNE <br /> 1121 NORTH ARM DR <br /> MOLJND,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 goveming 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. - <br /> � D�D �i �v ? � � �/7 <br /> Applicant Permitee Signature Date Issued B ignature Date <br />