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CITY OF ORONO * Z 0 1 6 - 0 0 3 0 1 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 04/OU2016 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 140 BROWN RD S <br /> PIN : 03-117-23-12-0011 <br /> LEGAL DESC : KALLESTAD ACRES <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FUEL STORAGE TANK REMOVAL <br /> VALUATION : $ 1,950.00 <br /> NOTE: INSPECTIONS ARE DONE BY FIRE MARSHALL,JAMES VAN EYLL. <br /> PLEASE CALL JAMES VAN EYLL DIRECTLY AT:(952)473-9701 TO SET UP AN INSPECTION. <br /> 1,000 GALLON TANK REMOVAL. <br /> PRE-BACKFILL INSPECTION REQUIRED. <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.98 <br /> DEAN'S TANK INC. MAIL-IN FEE 2.00 <br /> P.O. BOX 22515 <br /> ROBB[NSDALE,MN 55422 TOTAL 52.98 <br /> (763)535-0194 Payment(s) <br /> Minnesota State License#: BUIL-475 CREDIT CARD 7140 52.98 <br /> OWNER <br /> COLEMAN, MR.&MRS.DOUGLAS <br /> 140 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 I80 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 /> � �J _� _�-- L <br /> , _ --I�� � � � z � � � � <br /> __. <br /> � L; <br /> i t, L-_�' � � <br /> Applicant rmitee Signature Date Issued Signature Date <br />