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.. CITY OF ORONO * Z 0 1 2 — 0 0 9 2 1 * <br /> , <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/13/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3010 SOMERSET LA <br /> PIN : 04-117-23-22-0029 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD 2ND ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS L[NE ONLY <br /> VALUATION : $ 1,063.00 <br /> NOTF_,: GAS LINE NOR GAS POWGRED GENERA"I'OR <br /> APPLICANT MECHANICAL 50.00 <br /> DL JOHNSON HEATING STATE SURCHARGE MECH (VALUAT[ON) 0.53 <br /> 19620 JACKSON ST NE <br /> EAST BETHEL, MN 5501 1- TOTAL 50.53 <br /> (763)434-1248 <br /> OWNER <br /> CARSON,WALLACE& SHARYL <br /> 3010 SOMERSET LA <br /> LONG LAKE, MN 55356- <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. "fhis permit is for only the work described and does <br /> not grant permission for additiona)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[ime for ause. � <br /> - �.�.�_ l i� lao/.2 `�"' / � , 1�1�! ' G � � r�� /-� <br /> . ppli nt Permitee ignature Date Issued By Signature Date � <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />