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CITY OF ORONOI*l�l I I 1 1 11 1 1�� 11 I111 11 1 1 11 1 11 1 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/10/2018 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2500 DUNWOODY AVE <br /> PIN : 20-117-23-21-0019 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 003 BLOCK 007 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 500.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> 1 GAS LINE-KITCHEN RANGE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.25 <br /> B&B PLUMBING TOTAL 50.25 <br /> 25593 109TH ST Payment(s) <br /> ZIMMERMAN,MN 55398- CHECK 4323 50.25 <br /> (612)239-6149 6 <br /> Minnesota State License#:plbg-PC675878,mech-MB704145 <br /> OWNER <br /> ROSHOLT,JACOB&DEBRA <br /> 2500 DUNWOODY AVE <br /> WAYZATA,MN 55391- <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,applicable 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 /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This 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 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 th State Building Code.This permit may be <br /> revoked at any time fo d e aus <br /> /- q ! V <br /> Applicant ite- "ignature Date Issue. y Signature Date <br />