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' � CITY OF ORONO * 2 0 1 4 - 0 1 3 9 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/OS/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2835 CASCO PO[NT RD <br /> PIN : 20-117-23-31-0057 <br /> LEGAL DESC : SPRING PARK <br /> : LOT 114 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,500.00 <br /> NO"I�E: MENDOTf1 GAS FAC"I�ORY F[RF.PLACE <br /> APPLICANT MECHANICAL 56.25 <br /> STATE SURCHARGE MECH (VALUATION) 2.25 <br /> TWIN CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00 <br /> 6521 CECILIA CIR <br /> EDINA, MN 55439- TOTAL 60.50 <br /> (952)941-2685 Payment(s) <br /> Minnesota State License#: mech-MB682977 CHECK 200965 60.50 <br /> OWNER <br /> IVERSEN, ROSEMARY C <br /> 2835 CASCO PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work ibr which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State[3uilding Code. �This permit is for only thc work described and does <br /> not grant perniission for 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 specified herein.This permit will <br /> expire and become null and void if cons[ruc[ion authorized is not <br /> commenced within 180 days of the date of issuance,or i}'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 E�uilding Code.This permit may be <br /> revoked at am�time for due cause. <br /> C/ �' �/ � �e2 /V'� // <br /> Applicant Permitee Signature Date Issu By Signature Date <br />