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` CITY OF ORONO * 2 0 1 z - 0 0 1 6 5 * <br /> 2750 KELLEY PARKWAY UATE ISSUED: 03/OU2012 <br /> ' ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2165 COLIN DR <br /> PIN : 03-117-23-21-0017 <br /> LEGAL DESC : KELLEY GREEN <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE- WOOD <br /> VALUATION : $ 7,990.00 <br /> NOTI?: CHANGF."Il II? I'LIJI?TILES-NEW STAWLGSS STEEL LINGR <br /> APPLICANT MECHANICAL 99.88 <br /> ]ST CHOICE CHIMNEY COMPANY STATE SURCHARGE MECH (VALUATION) 4.00 <br /> 4179 149TH AVE NW <br /> ANDOVER, MN 55304- TOTAL 103.88 <br /> (763)422-0481 PAID WITH CC# 0171 <br /> OWIYER <br /> EARLING,JOHN <br /> 2165 COLIN DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> "l�he work for which this permit is issucd shall be performed according to <br /> the approvcd plans and specifications,applicable City approvals,and the <br /> State[3uilding Code. This permit is for only the work described and does <br /> not grant permission 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 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 lor a period of 180 days at any time aRer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requcsted in conformance with the State F3uilding Code.This permit may be <br /> revoked at any time ior due cause. <br /> 4 �_ �y�� 3i�< i �t� G �i �/ i / a- <br /> App ica�t Permitee Signa�ure Date [ssue By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />