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CITY OF ORONO * 2 0 1 2 - 0 1 1 4 2 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/08/2012 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS 2575 THOROUGHBRED LA <br /> PIN 04-117-23-I1-0021 <br /> LEGAL DESC OLD CRYSTAL BAY ROAD 2ND ADDN <br /> LOT 004 BLOCK 002 <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIREPLACE-GAS <br /> VALUATION $ 2,500.00 <br /> NOTE: (1)TRAVIS GAS FACTORY FIREPLACE-MODEL NO.98500242 <br /> APPLICANT MECHANICAL 50.00 <br /> PRACTICAL SYSTEMS STATE SURCHARGE MECH(VALUATION) 1.25 <br /> 4342 B SHADY OAK RD <br /> HOPKINS,MN 55343 TOTAL 51.25 <br /> (952)933-1868 <br /> OWNER <br /> SAPLETAL, STEVEN&STACY <br /> 2575 THOROUGHBRED LA <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 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 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 Cod . Is ermit may be <br /> revoked at any time for due cause. / <br /> /l / l <br /> 4kPrfCatil Penyiitee Signatur Date lssu6Qy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />