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- CITY OF ORONO * 2 0 1 6 - 0 0 0 2 9 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: OU1U2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1224 BRIAR ST <br /> P[N : 10-117-23-31-0074 <br /> LEGAL DESC : MAXWEI.LS ADDN CRYSTAL BAY LAKE <br /> : LOT 000 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,300.00 <br /> NOTE: NEW: HEAT N'GLO FIREPLACG <br /> APPLICANT MECHAMCAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 1.15 <br /> FIRESIDE HEARTH& HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 53.15 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CHECK 00020054 53.15 <br /> OWNER <br /> HILL[ER,JAMES <br /> 1224 BRIAR ST <br /> WAYZATA, MN 55391- <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 sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This pertnit 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 aRer 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. ���.��-�a <br /> „ � � � �_ �, , � �� �� l_ {. �� ; <br /> r1 �_ 1 ; ��_- > � _ � <br /> 1�';,. � � '` �� � �' `t ���- ' 1� , J( , ;i� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />