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CITY OF ORONO * z 0 1 5 - 0 0 9 3 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/27/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1392 BALDUR PARK RD <br /> PIN : 08-117-23-31-0003 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 500.00 <br /> NOTE: GASLINE TO FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.25 <br /> STEWART PLUMBING, INC. MAIL-IN FEE 2.00 <br /> 13025 GEORGE WEBER DR <br /> SUITE#1 TOTAL 52.25 <br /> ROGERS, MN 55374 Payment(s) <br /> (763)428-1833 52.25 <br /> Minnesota State License#: plbg-PC000474,mech-MB003262 <br /> OWNER <br /> GEHLE, GILBERT <br /> 1392 BALDUR PARK RD <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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � � � �7 ��`7 /l5 <br /> Applicant Permitee Signature Date Issued Signature Date <br />