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CITY OF ORONO PERMIT NO.: 2011-01350 <br /> .., <br /> 2750 KELLEY PARKWAY <br /> . ORONO, MN 55356- DATE ISSUED: 10/28/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3405 HIGH LA <br /> PIN : OS-117-23-11-0002 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0843 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 1,000.00 <br /> NOTE: 1 KITCHEN EXHAUST <br /> GAS LINE TO RELOCATE STOVE <br /> APPLICANT MECHANICAL 50.00 <br /> FLARE HEATING&AIR COND STATE SURCHARGE MECH(VALUATION) 0.50 <br /> 9309 PLYMOUTH AVE N <br /> SUITE 104 MAIL-IN FEE 6.50 <br /> GOLDEN VALLEY, MN 55427 MISC FEE <br /> (763)542-1166 TOTAL 57.00 <br /> OWNER <br /> REILLY, KEVIN& DENISE <br /> 3405 HIGH LA <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> 1'he work for which this permit is issued shall be pertormed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permi[is for only the work described and does <br /> no[grant pennission 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 atter work has commenced. <br /> 'Che applicant is responsible for assuring all required inspections are <br /> requested in conformance wi[h[he State Building Code.This permit may be <br /> revoked at any time for�ue cause. <br /> l�%V��r �, �� / / l l <br /> v-ai�.G <br /> Applicant Permitee Signature Date Issued By Si ature e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABO . <br />