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� � CITY OF ORONO PERMIT NO.: 2oos-oo236 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 09/18/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2264 SHADYV�OOD RD <br /> PIN : 17-117-23-43-0124 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,805.00 <br /> NOTE: <br /> INSTALL GAS FIREPLACE-BRAND NAME: HEATALATOR-MODEL NO.GDCH60I <br /> GASLINE WILL BE RUN BY OTHER CONTRACTOR. <br /> APPLICANT �CHANICAL 47.56 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 1.90 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 49.46 <br /> (651)633-2561 <br /> Minnesota State License#:20512060 <br /> OWNER <br /> ZIEGLER,THOMAS <br /> 2264 SHADYWOOD 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 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 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 use.G� <br /> � � (� � v� � _ / �� �� <br /> pli t Permitee Signature Date I ed By Sign re Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />