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* ' CITY OF ORONO PERMIT NO.: 2011-00541 <br /> ` 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 06/28/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 766 BRIDGEWATER DR <br /> PIN : 33-118-23-11-0109 <br /> LEGAL DESC : STONEBAY FOURTH ADDITION <br /> : LOT 014 BLOCK 001 <br /> PERMIT TYPE : MECHAN[CAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> NOTE: REPLACE GAS DRYER,FLEX LING&DRIP LEG <br /> APPLICANT MECHANICAL(<$S00) 15.00 <br /> CENTER POINT ENERGY MINNEGASCO STATE SURCHARGE MECH(<$500) 5.00 <br /> 9320 EVERGREEN BLVD NW <br /> SUITE B MAIL-IN FEE 2.00 <br /> COON RAPIDS, MN 55433 MISC FEE 0.00 <br /> (�63>�s�-6zoz TOTaL zz.00 <br /> OWNER <br /> PETERSON, LEE& DARLENE <br /> 766 BR[DGEWATER DR <br /> LONG LAKE, MN 55356- <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 atter 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-eause. <br /> `�iyt�Q'� �i11, � � ��� l l <br /> Applicant Permitee Signature Date Issued By i nature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />