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� CITY OF ORONO PERMIT NO.: 20��-o�3os <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEu: 10/24/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3380 GRAHAM HILL RD <br /> PIN : OS-117-23-11-0013 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 2 <br /> : LOT 5 BLOCK 2 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULT[PLE <br /> VALUATION : $ 1,300.00 <br /> NOT�: I RAY HGATING SYSTEM <br /> 1 GAS LINE TO POOL HEATER <br /> APPLICANT <br /> MECHANICAL 50.00 <br /> METRO GAS INSTALLERS STATE SURCHARGE MECH (VALUAT[ON) 0.65 <br /> 685 141ST LANE NW TOTAL 50.65 <br /> ANDOVER,MN 55304 <br /> (76�)754-7119 <br /> OWNER <br /> RUDOW, DAVID& LESLIE <br /> 3380 GRAHAM HILL RD <br /> ORONO, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for�vhich this permit is issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Building Cude. This permit is for only the work described and does <br /> not grant permission for addi[ional or related work which requires separate <br /> pennits. All provisions of laws and ordinances governing this type of wark <br /> shall be compied with Hhether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced wi[hin l80 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 /> I�he applicant is responsible r assuring all required inspections are <br /> requested in confonn ce ith the State Bui � Code.This permit may be <br /> revoked at any ti or e ca � <br /> � � � ��'' / / <br /> / / <br /> Applica t Permitee Signature Date Issued By S' ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />