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CITY OF ORONO PERMIT NO.: 2011-01333 <br /> � 2750 KELLEY PARKWAY <br /> • � ORONO, MN 55356- DATE�1ssuE�: 10/26/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1685 FOX ST <br /> PIN : 03-117-23-44-0004 �� <br /> LEGAL DESC : HANSER ADDN ��� <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : GAS L[NE ONLY <br /> NOTE: GAS LING TO RANGE&DRYGR <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> SOUTHTOWN PLUMBING INC. STATE SURCHARGE MECH(<$500) 5.00 <br /> 6636 PENN <br /> R[CHFIELD, MN 55423 MAIL-IN FEE 2.00 <br /> (612) 866-3057 TOTAL 22.00 <br /> OWNER <br /> HORNIG, STEVEN <br /> 1685 FOX ST <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 [he <br /> State Building Code. This permit is for only[he 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��hether 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 fortdue cause. <br /> `�-� � / / / / <br /> Applicant Permitee Signature Date Issued By gnature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED A OVE. <br />