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CITY OF ORONO * Z 0 1 4 - 0 0 8 7 3 * <br /> ` ^ 2750 KF.LLEY PAItKWAY DATE ISSUEll: 08/12/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 805 FOREST ARMS I,A <br /> PIN : 07-117-23-12-0009 <br /> LEGAL DESC : FOREST ARMS <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUAT[ON : $ 1,850.00 <br /> NOTF.: GnSLING"I O POOL <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 0.93 <br /> METRO GAS INSTALLERS TOTAL 50.93 <br /> 685 141ST LANE NW Payment(s) <br /> ANDOVER, MN 55304 <br /> (763)754-71 19 CHECK 14882 50.93 <br /> Minnesota State License#: mech-MB003162 <br /> OWNER <br /> FELDMANN,JOSEPH & DONFLLE <br /> 805 FOREST ARMS LA <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work Ibr which this permit is issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. "I his permit is for onlv the work described and docs <br /> not grant permission tbr additional or related work which rcquires separate <br /> permits. All provisions of laws and ordinances goveming 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 f�or 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 duc cause. � <br /> �� �,� �"�`j�� �` � /�/ <br /> � � � <br /> App icant Permitee,ignature Datc Is_ d I3y Signature Date <br />