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CITY OF ORONO * z 0 1 3 - 0 1 1 0 5 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 10/2U2013 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 760 BROWN RD S <br /> PIN : 03-117-23-43-0004 <br /> LEGAL DESC : UNPLATTED 03 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,000.00 <br /> NOTE: QUADRA FIRE GAS FP <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH(VALUATION) 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 TOTAL 54.00 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> BROWNE, MR.& MRS. <br /> 760 BROWN RD S <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. "rhis permit is for only[he work described and does <br /> not grant permission tbr 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 specitied 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 S4ate Building Code.This permit may be <br /> revoked at any time for du�cause. <br /> v�l.� l l l l <br /> Applicant Permitee Signature Date Issued By Si ture te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED A O . <br />