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' ' CITY OF ORONO * Z p� 1 5 - 0 0 7 7 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/16/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2690 CAROLINE AVE <br /> PIN : 20-117-23-24-0033 <br /> LEGAL DESC : WESSELS SUBD OF SPRING PARK LO <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> NOTE: CONNECT GASLINE TO OUTDOOR GRILL. <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> STATE SURCHARGE MECH(<$500) 5.00 <br /> PRACTICAL SYSTEMS MAIL-1N FEE 2.00 <br /> 4342B SHADY OAK RD <br /> HOPKINS, MN 55343 TOTAL 22.00 <br /> (952)933-1868 Payment(s) <br /> CREDIT CARD 5815 22.00 <br /> OWNER <br /> LIBERMAN,ZN&TAL <br /> 2690 CAROLINE AVE <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 /> . ' <br /> � D �-�r,� !o � /�� l� <br /> Applicant Permitee Signature � Date Issued Signature Date <br />