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CITY OF ORONO * 2 0 1 5 - 0 0 5 4 S * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: OS/06/2015 <br /> ORONO, MN 55356- <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1420 SHORELINE DR <br /> PIN : 11-117-23-22-0015 <br /> LEGAL DESC : DRAGONFLY HILL <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 900.00 <br /> NOTE: GAS LINE FOR A GENERATOR <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.45 <br /> SELECT MECHANICAL SERVICES INC. MAIL-IN FEE 2.00 <br /> 6219 CAMBRIDGE ST <br /> ST. LOUIS PARK, MN 55416- TOTAL 52.45 <br /> (952)926-4488 Payment(s) <br /> CREDIT CARD 8605 52.45 <br /> OW1vER <br /> FELDSHON, DAVID&ARCHELLE <br /> 1420 SHORELINE DR <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 sepuate <br /> permits. All provisions of Iaws 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. � <br /> /(J' <br /> , , _. <br /> �y � C�� � �:�t,�t -�--<_ t_ �����_��, `-� , �4- , ,� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />