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. • CITY OF ORONO * 2 0 1 4 — P1 0 7 7 6 * <br /> 2750 KFLLEY PARKWAY pATE iSSUEn: 07/23/2014 <br /> ORONO, MN 553_56- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 736 DICKEY LAKE DR <br /> PIN : 27-118-23-33-0006 <br /> LEGAL DESC : RINGERSWOOD <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 925.00 <br /> NU"I�F: GASI.IN1:FOR FU"1'URE OUTDOOR GRILI.n'�D GAS COOK�I�OP <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 0.50 <br /> CENTER POINT ENERGY MINNEGASCO M�11L-IN FEE 2.00 <br /> 9320 EVERGREEN BLVD NW <br /> SUITE B TOTAL 52.50 <br /> COON RAPIDS, MN 55��3 Payment(s) <br /> (763)757-6202 CHECK 18651 52.50 <br /> OWNER <br /> HOYT TRUSTEE, JOHN L <br /> 736 DICKEY LAKE DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work for���hich this permit is issued shall be perlormed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State Building Code. 'I�his permit is for only the work described and does <br /> not grant pennission for additional or related work which requires separate <br /> permits. All provisions oY laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.'I�his 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 ot� 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 l3uilding Codc.'I'his permit may be <br /> revoked at any time for duc cause. <br /> � C�i'�t�a�- 7 � �3�/ <br /> Applicant Permitee Signature Dat Issu� By Signature Date <br />