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CITY OF ORONO ���������������q������������ <br /> ` � 2750 KELLEY PARKWAY * 2 0 1 4 — PJ 1 2 2 5 * <br /> DATE ISSUED: 10/22/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: 952)249-4616 <br /> ADDRESS : 1480 SIXTH AVE N <br /> PIN : 26-118-23-32-0008 <br /> LEGAL DESC : DOUGLAS ESTATES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-WOOD <br /> VALUATION : $ 8,900.00 <br /> NOTE: WOOD BURNING FIREPLACE-HHT RUTHERFORD-50-B <br /> APPLICANT MECHANICAL 111.25 <br /> STATE SURCHARGE MECH(VALUATION) 4.45 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 117.70 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CREDIT CARD 4608 117.70 <br /> OWNER <br /> GULBRANDSON,DAN&ERICKA � <br /> 1480 SIXTH AVE N <br /> LONG LAKE,MN 55356- <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. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permiu. 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections ar� <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �e--�� c-.�� �� �'aT� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />