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` - CITY OF ORONO I 'I 11 I <br /> * 20 1 8 - 00454 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/12/2018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 755 FERNDALE RD N <br /> PIN : 36-118-23-11-0028 <br /> LEGAL DESC : LYDIARD HILLS <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 450.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> GASLINE FOR STOVE <br /> APPLICANT MECHANICAL 50.00 <br /> FREEDOM MECHANICAL STATE SURCHARGE MECH(VALUATION) 0.23 <br /> 8382 172ND AVE SE TOTAL 50.23 <br /> BECKER,MN 55308- <br /> Payment(s) <br /> (612)363-6190 CREDIT CARD 9429 50.23 <br /> Minnesota State License#:mech-004042PM,plbg-PC642836 <br /> OWNER <br /> SCHMEISSER,FREDERICK&KAREN <br /> 755 FERNDALE RD N <br /> WAYZATA,MN 55391- <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 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 /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> A '• & cth..J kirs-r) / /7_, /8, <br /> Applicant Permitee Signature Date Issued Bygnature Date <br />