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� CITY OF ORONO * Z 0 1 5 — 0 0 6 9 � * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 06/02/2015 <br /> ORONO, MN 55356- <br /> 9 2 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3225 CASCO CIR <br /> PIN : 20-117-23-43-0021 <br /> LEGAL DESC : SPRING PARK <br /> : LOT 029 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CO1�ISTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,622.00 <br /> NOTE: TOWN&COUNTRY GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.81 <br /> GLOWING HEARTH AND HOME MAIL-IN FEE 2.00 <br /> 100 ELDORADO DRIVE <br /> JORDAN,MN 55352 TOTAL 53.81 <br /> (952)495-2927 Payment(s) <br /> CHECK 21047 53.81 <br /> OWNER <br /> LEESTMA, MARTIN&KATHRYN <br /> 3225 CASCO CIR <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 separat <br /> permits. All provisions of laws and ordinances goveming this type of wo <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 commence <br /> The applicant is responsible for assuring all requiced inspections are -� <br /> requested in conformance with the State Building Code.This permit may e � \ . � �',� <br /> revoked at any time for du ca e. - {.` � C <br /> i \ (�C/l-,k ��..' �� � ���� 1 <br /> 7G��`-f�� <br /> , <br /> i i <br /> Applicant Permitee Signature Date Issued By Signature Date <br />