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CITY OF ORONO * Z 0 1 6 — 0 1 2 6 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/OS/2016 <br /> r� <br /> ORONO, MN 55356— <br /> s (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2000 SHADYWOOD RD <br /> PIN : 17-117-23-31-0001 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHAMCAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,500.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> PER CONTRACTOR,SOMEONE ELSE WILL BE RLJNNING THE GAS LINES. <br /> NEW GAS FIREPLACE(SUPERIOR) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.75 <br /> HAGEN FIREPLACE SOLUTIONS TOTAL 50.75 <br /> 435 FAIRVIEW AVE N Payment(s) <br /> L1NIT 2 CHECK 2606 50.75 <br /> ST PAUL, MN 55104- <br /> (612) 839-7595 <br /> Minnesota State License#: mech-MB680260 <br /> OWNER <br /> Sustainable 9 Holdings LLC <br /> 124 MAIN ST SE <br /> SUITE#343 <br /> MINNEAPOLIS,MN 55414- <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 pennit will <br /> expire and become null and void ifconstruction 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. ��j <br /> �r �Vz-e-.-- �6 1 C,� ��c�� 1��--� `f�Z, r G� S � C(o <br /> Applicant Permitee Signature Da e Issued By Signature Date <br />