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PERMIT <br /> CITY OF ORONO PERMIT TYPE: <br /> 2750 Kelley Parkway- P.O. Box 66 MECHANICAL <br /> Crystal Bay, Minnesota 55323 Permit Number: ;;;t E;: F <br /> (612) 473-7357 Date Issued: 04/03/96 <br /> SITE ADDRESS: <br /> 4 145 WATER I OWN RD <br /> LSV <br /> P. I . N . r :::1-118-23-41-0003 <br /> DESCRIPTION: <br /> F I REP'LA4 F <br /> 1 FIREPLACE MAKE MA•i ES T IC MODEL '3H-:35 <br /> REMARKS: <br /> FEE SUMMARY: <br /> VALUATION $1 , 000 <br /> Base Fee $35 . 00 <br /> r:0 <br /> Surcharge _ y F.0 <br /> Total Fee $:. . 50 <br /> CONTRACTOR: - Applicant - OWNER: <br /> H H SEIFERT c:ON'.E:{ 3E:4 s3797 7 D-- :t.r FARI <br /> 12460 WAYZATA BLVD 4045 WA T ERTOWN RD <br /> t i I NNE:T 1_.NK:A ASN E. ;30s ORONO MN SEv;359 <br /> (6,1 ) .545--:3797 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENT'= <br /> SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF <br /> ORONO ORDINANCES AND STATE OF MINNESOTA E:U UILDING CODE REQUIREMENTS. <br /> L_ <br /> 1 e (--6V) <br /> APPLICANTPERMITEE SIGNATURE ISSUED BY:SIGNATURE <br />