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, , , CITY OF ORONO �z B 1 5 - 0 0 7 0 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/03/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 15 BROWN RD S <br /> PIN : 34-118-23-34-0010 <br /> LEGAL DESC : UNPLATTED 34 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 500.00 <br /> NOTE: GAS LINE FOR GENERATOR-NEAR HIGH PRESSURE GAS METER <br /> APPLICANT MECHANICAL 50.00 <br /> PRACTICAL SYSTEMS STATE SURCHARGE MECH(VALUATION) 0.25 <br /> 4342B SHADY OAK RD MAIL-IN FEE 2.00 <br /> HOPKINS,MN 55343 TOTAL 52.25 <br /> (952)933-1868 Payment(s) <br /> CREDIT CARD 5815 52.25 <br /> OWNER <br /> EISS,JOHN&BONNIE <br /> 15 BROWN RD S <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 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 /> � �- <br /> 1 �--�:-? ��_ � �-�� <br /> Applicant Permitee Signature Date Issue By Signature • Date <br />