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CITY OF ORONO * 2 0 1 2 — P1 0 2 6 5 * <br /> , 2750 KELLEY PARKWAY DATE ISSUED: 04/09/2012 <br /> s ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2755 CASCO POWT RD <br /> PIN : 20-117-23-23-0007 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.265 <br /> : LOT 007 BLOCK 000 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,000.00 <br /> NOTG: 1 HGAT N GLO 8000C-IPI <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 1.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (65l)633-2561 M]SC FEE 0.00 <br /> Minnesota State License#:20512060 TOTAL 53.00 <br /> OWNER <br /> BASKFIELD, MICHEAL& SHARON <br /> 2755 CASCO PT RD <br /> WAYZATA, MN 55391- <br /> ACREEMENT AND SWORN STATEMENT <br /> The worfi 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. '�his permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> parmits. 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 /> 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 State Building Code.This permit may be <br /> revoked at any time for duc cause. <br /> ��'vl.� �— / / ��j�Gi'yL,Q�n l l <br /> Applicant Permitee Signature Date Issued By ignature ate <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />