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CITY OF ORONO * 2 0 1 7 — 0 1 5 7 5 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/30/2017 <br /> ORONO,MN 55356- <br /> 952)249-4600 FAX: (952)249-4616 <br /> ADDRESS 3265 SHADYWOOD CIR <br /> PIN 20-117-23-11-0048 <br /> LEGAL DESC SHADYWOOD VILLAS <br /> LOT 7 BLOCK 1 <br /> PERMIT TYPE MECHANICAL <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIREPLACE-GAS <br /> VALUATION $ 1,735.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> GAS FIREPLACE-MODEL 6000C <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 0.87 <br /> 2700 FAIRVIEW AVE MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 52.87 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 52.87 <br /> OWNER <br /> Charles Cudd LLC <br /> 15050 23RD AVE N <br /> PLYMOUTH,MN 55441- <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 Code.This permit may be <br /> revoked at any time for due cause. <br /> I kv<,,v t 97W/ A <br /> Applicant Permitee Signature Date Issued By S ature Date <br />