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� � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 5 - 0 1 4 7 0 * <br /> DATE ISSUED: 1 U17/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2498 SANDSTONE LA <br /> PIN : 33-118-23-11-0022 <br /> LEGAL DESC : STONEBAY <br /> : LOT 019 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,795.00 <br /> NOTE: GAS FIREPLACE HEAT-N-GLO <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 0.90 <br /> 2700 FAIRVIEW AVE MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 52.90 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4608 52.90 <br /> OWNER <br /> Wooddale Builders Inc <br /> 6117 BLUE CIRCLE DR <br /> SUITE 101 <br /> MINNETONKA,MN 55343- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfortned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1'his permit is for only the work described and dces <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 l80 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 /> � <br /> GQ. er" ..� // ��7 ��S <br /> Applicant Permitee Signature Date I su d y Signature Date <br />