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CITY OF ORONO PERMIT NO.: 2010-00587 <br /> ` 2750 KELLEY PARKWAY <br /> � <br /> ORONO, MN 55356- �ATE [SS[1ED: 07/15/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2775 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0016 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 001 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 1,700.00 <br /> NOTE: GAS LINE ONLY TO POOL HEATER&SPA HEATER <br /> APPLICANT MECHANICAL 50.00 <br /> METRO GAS INSTALLERS STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 685 141ST LANE NW TOTAL 55.00 <br /> ANDOVER, MN 55304 <br /> (763)754-7119 <br /> OWNER <br /> MURLEY,TODD&MARY <br /> 2755 COUNTRYSIDE DR W <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,applicabie 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 /> permi[s. All provisions of laws and ordinances goveming[his type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expi�e and bccome 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 l80 days at any time afier work has commenced. <br /> Thc applicant is responsibl for assuring all required inspections are <br /> reques[ed in confo man ith the State B ' ' g Code.This permit may be <br /> revoked at e due e. <br /> l l / G��� � `7 - �,S� � <br /> Applicant Permitee Signature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />