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r w <br /> CITY OF ORONO * 2 0 1 8 - a 0 1 9 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/23/2018 <br /> ORONO,MN 5535Cr <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1720 SHADYWOOD RD <br /> PIN : 17-117-23-21-0019 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL - <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,795.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> HHT GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.90 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 53.90 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 53.90 <br /> OWNER <br /> HANSBERGER,TRAVIS <br /> 651 LEXIE CT <br /> EAGAN,MN 55123- <br /> AGREEMENT AND SWORI�i 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 rype of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction suthorized 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 /> � �� �,, �-� <br /> Applicant Permitee Signature Date Issued By ature Date <br />