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CITY OF ORONO � 1 2 — 0 0 7 s 0 * <br /> • "`� 2750 KELLEY PARKWAY DATE ISSUED: 08/13/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2905 SIXTH AVE N <br /> PIN : 28-118-23-31-0006 <br /> LEGAL DESC : GARDEN GROVE <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE- WOOD <br /> NOTE: RF,PLACE WOOD BURNING FIREPLACE-KOZY HEAT-MODEL 231 7C <br /> APPLICANT MECHANICAL(<$500) 15.00 <br /> ELLINGSON,JORGEN& YUMIKO STATE SURCHARGE MECH(<$500) 5.00 <br /> 2905 SIXTH AVE N TOTAL 20.00 <br /> LONG LAKE, MN 55356- <br /> PAID WITH CC# 7577 <br /> OWNER <br /> ELL[NGSON,JORGEN&YUMIKO <br /> 2905 SIXTH AVE N <br /> LONG LAKE,MN 55356- <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 gran[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 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 l80 days at any time afrer work has commenced. <br /> The applicant is r o sible 'Asuring all required inspections are <br /> requested in c or an i the State Building Code.This permit may be <br /> revoked at y � �' r d�e`ca / <br /> � �� .,' 6 . �� 1'1 <br /> �' �-.' - - ��i 1 3 i t'z � � i i <br /> �'ant Permitee Signature Date Issu By Signature Date <br /> �' SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />