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Ak <br /> BEFEUMM <br /> CITY OF ORONO * 2 0 1 6 — 0 1 5 1 4 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/05/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS 220 NORTHGATE RD <br /> PIN 36-118-23-41-0051 <br /> LEGAL DESC NORTHGATE TWO <br /> LOT 001 BLOCK 007 <br /> PERMIT TYPE MECHANICAL <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE GAS LINE ONLY <br /> VALUATION $ 1,000.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> GARAGE UNIT SUPPLIED BY OTHERS. THIS PERMIT IS ONLY FOR HANG AND GASLINE ONLY <br /> APPLICANT MECHANICAL 50.00 <br /> PROFESSIONAL MECHANICAL SERVICES <br /> STATE SURCHARGE MECH(VALUATION) 0.50 18983 YORK STREET NW MAIL-IN FEE 2.00 <br /> SUITE C TOTAL 52.50 <br /> ELK RIVER,MN 55330- Payment(s) <br /> (763)657-7421 CHECK 2595 52.50 <br /> Minnesota State License#:mech-MB003767 <br /> OWNER <br /> DAU,EDWARD&MICHELL <br /> 220 NORTHGATE RD <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 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 /> IC, cc <br /> Applicant Permitee Signature ate Issued By Sijhature Date <br />