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CITY OF ORONO * Z 0 1 5 - 0 0 9 6 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/29/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3630 EILEEN ST <br /> p[� : OS-117-23-21-0013 <br /> LEGAL DESC : RIEDEL CO STUBBS BAY ADDN <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) ( <br /> PROPERTY TYPE : RES[DENTIAL \' <br /> CONSTRUCTION TYPE : GAS LINE ONLY <br /> VALUATION : $ 500.00 <br /> NOTE: GASLINE FOR(2)FIREPLACES,OUTDOOR GRILL AND GAS STOVE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.25 <br /> RELIABLE PLUMBING LLC TOTAL 50.25 <br /> 17822 LINCOLN STREET NW Payment(s) <br /> ELK RIVER, MN 55330- CHECK 4075 50.25 <br /> (763)443-7411 <br /> Minnesota State License#: plbg-PC644738 <br /> OWNER <br /> MCCUTCHEON, MARK&JAYME <br /> 3630 EILEEN ST <br /> MAPLE PLAIN, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 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 inspec[ions aze <br /> requested in confor e with the State Build Code.This permit may be <br /> revo d at any time ue cause. • <br /> � <br /> �' 2°I �� -�;C�� �7 �Z-�� /s <br /> Appl c t m' ee ignature Da e Issu d ignature Date <br />