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CITY OF ORONO * Z 0 1 6 - PJ 1 5 1 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/02/2016 <br /> � � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1670 SHADYWOOD RD <br /> PIN : 17-117-23-21-0015 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 500.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> NEW GAS LINE FOR OUTSIDE GENERATOR <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 025 <br /> PETERS PLUMBING TOTAL 50.25 <br /> 20455 MANOR ROAD Payment(s) <br /> EXCELSIOR,MN 55331- CREDIT CARD 4025 5025 <br /> (612) 803-5066 <br /> Minnesota State License#:plbg-PM093027,mech-MB669934 <br /> OWNER <br /> KIELLEY, DONALD&ARLENE <br /> 1670 SHADYWOOD RD <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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in wnformance with the State Building Code.This permit may be �%�, <br /> revoked at any time for due cause. � <br /> �� � -�.��_�����'"_ _ (� �"i—Li� ����� � �, ��, �/ ��." <br /> �_.. <br /> Appli ' Per i e Signature Date Issued By Signature Date <br />