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CITY OF ORONO PEaM�T No.: 2oio-oi162 <br /> ' 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- �A7'E IssvE�: 1U30/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS . 3382 BAYSIDB RD IvG�" <br /> PIN : OS-117-23-14-OQ35 ��G��j <br /> LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK <br /> : LOT 009 BLOCK 005 <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,500.00 <br /> NOTE: 2 1IGATN GLO GAS FIREPLACE <br /> 6000C <br /> APPLICANT MECHANICAL 56.25 <br /> FtRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 5.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MA[L-IN FEE 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 63.25 <br /> OWNER <br /> HUTHWAITE, M[CHAEL& MARILYN <br /> 7715 AINSWORTH DR <br /> GERMANTOWN, TN 38138- <br /> AGREEMENT AND SWORN STATEMENT <br /> The�vork for which this pennit is issued shall be perfonned accordin�to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 'I�his permit is ibr only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. nll provisions of laws and ordinances governing this type of work <br /> shall be compied wiUi whether or not specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the datc of issuance,or if conslruction is <br /> suspended for a period of 180 days at airy timc atter work has commenced. <br /> The applicant is responsibie for assuring all required inspections are <br /> I requested in conformance wilh the State Building Code.This permit ma��be <br /> revoked at any time for duc cause. <br /> i I�K.�-C.l ��. l l <br /> i i <br /> Applicant Permitee Signature Date Issued By ' nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB VE. <br />