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CITY OF ORONO I I 1 1 1 1 1 I II 1111111111111'1111111 <br /> * 2 0 1 6 - 00 6 5 2 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/07/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2610 WEST LAFAYETTE RD <br /> PIN : 21-117-23-24-0043 <br /> LEGAL DESC : SHORE HILLS <br /> : LOT 011 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,500.00 <br /> NOTE: (1)MENDOTA GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.25 <br /> TWIN CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00 <br /> 6521 CECILIA CIR <br /> EDINA,MN 55439- TOTAL 53.25 <br /> (952)777-4125 Payment(s) <br /> Minnesota State License#:mech-MB682977 CREDIT CARD 9659 5 7 y S 53.25 <br /> OWNER <br /> ENQUIST,CYNTHIA <br /> 2610 WEST LAFAYETTE RD <br /> EXCELSIOR,MN 55331 <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 /> t 1 <br /> • ' • , Pe-C h � ? l <br /> Applicant Permitee Signature J Date Issuedy signature Date <br />