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. � <br /> CITY OF ORONO * 2 0 1 4 - 0 0 9 3 6 * <br /> 2750 KELLEY PARKWAY DA'rE ISSUED: 08/22/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4060 DAHL RD <br /> PIN : 07-117-23-I1-0020 <br /> LEGAL DESC : PIRATGS COVE <br /> : LOT 016 BLOCK 001 <br /> PERMIT TYVE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RF.SIDENT'IAL <br /> CONSTRUCTfON TYPE : GAS LINE ONLY <br /> NO"I�E: UAS1.1Nt?'I�O GF.M�:Ri��I�OR[3l?I IIND GAR�1Gf�:. <br /> APPLICANT MECHANICA[.,(<$500) 15.00 <br /> STATE SURCHARGE MECH (<$500) 5.00 <br /> ASPEN VENT[LATION & HEA"1�[NG CO. TOTAL 20.00 <br /> 9815 P[ONLER TRAIL <br /> LORETTO, MN 55357 Payment(s) <br /> (763)498-7053 CREDIT CARD 3758 20.00 <br /> OWNER <br /> NEVF,JR,J & J <br /> 4060 DAHL RD <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> I'he work 1�or which this permit is issued shall bc performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State E3uilding Code. This perniit is for only the work described and does <br /> not grant pennission 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 specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of[he date oT issuance,or if construction is <br /> suspended for a period ot� l80 days at any time afrer work has commeneed. <br /> The applicant is responsible for assuring aIl required inspections are <br /> requested in conformance with the State Buildin�Code.This pern�it may be <br /> revoked at any time for d cause. <br /> ���- / O � ���/ <br /> pplicant Permitee Signature D tc Issu By Signatur� Date <br />