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CITY OF ORONO * 2 �1 1 2 — 0 1 1 0 6 * <br /> 2750 KELLEY PARKWAY DATE �ssuED: 10/3U2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3025 CASCO POINT RD <br /> PIN : 20-ll 7-23-34-0002 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0394 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENT[AL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,000.00 <br /> NOTE: GAS FACTORY FIREPLACE-HEATH&GLO-MODGL ESCAPE I35 <br /> APPLICANT MECHANICAL 50.00 <br /> COUNTRYSIDE SERVICES STATE SURCHARGE MECH (VALUATION) 2.00 <br /> 6511 HWY 12 <br /> MAPLE PLAIN, MN 55359 TOTAL 52.00 <br /> (763)479-1600 <br /> OWNER <br /> STANDA, SCOTT& IRENE <br /> 3025 CASCO POINT RD <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 Uic <br /> State Building Code. This permit is for only Ihe work described and does <br /> not grant pennission for additional or related work which requires separatc <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 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 /> Thc applicant is responsible for assuring all required inspec[ions are <br /> requested i conformance with[he State Building Code."i'his permit may bc <br /> revoked ny time,fo due cause. <br /> '� � fai 51 i � .2 _ l(7 �� � � � � <br /> Applicant Permitee Signature Date Iss e By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />