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' CITY OF ORO PERMIT NO.: 2012�00077 <br /> 2750 KELLEY PARK AY <br /> ORONO, MN 5535 - DATE ISSUEn: 02/07/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4105 BAYS[DE RD <br /> P1N : 06-117-23-14-0023 <br /> LEGAL DESC : BAYSIDE RIDGE <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 5,000.00 <br /> NOTL-;: GAS FACTORY FIREPLACE-BRAND NAME-REGENCY-MODEL#H 40E <br /> GASLINE DONE BY OTHERS <br /> APPLICANT MECHA CAL 62.50 <br /> STOVE& FIREPLACE STATE S RCHARGE MECH(VALUATION) 2.50 <br /> 255 HWY 97 <br /> FOREST LAKE, MN 55025- TOTAL 65.00 <br /> (651)464-9761 <br /> OWNER <br /> BURKE,NICK& SUE <br /> 4105 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he tiork for which this permit is issued shall be performed according to <br /> the approved plans and specificauons,applicable City approvals,and the <br /> Sta�e Building Code. This permit is for onty the work described and does <br /> not grant permission for additional or related work which requices separate <br /> pennits. 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 /> cxpire 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 afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoke�at a �' e for due cause. <br /> � �L"f, % �G �� �� � /'�(� <br /> � �� �.���e 1.(�,�/���'`` l � l � � `i K � 1��� <br /> Applicant Permitee Signature Date Is e y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK T ER THAN DESCRIBED ABOVE. <br />