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CITY OF ORONO * z 0 1 3 - 0 PJ 3 0 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/30/2013 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1480 BRACKETTS POINT RD <br /> PIN : 11-117-23-33-0005 <br /> LEGAL DESC : BRACKETTS PO1NT <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 6,000.00 <br /> NOTE: HEAT N GLO TRUF,36 <br /> APPLICANT MECHANICAL 75.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH (VALUATION) 3.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 551 13 MAIL-IN FEE 2.00 <br /> (651)633-2561 TOTAL 80.00 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> HEADRICK, MARK&LAURIE <br /> 1480 BRACKETTS PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performcd according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only[he work described and does <br /> not gran[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 permi[will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 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 due cause. <br /> ��� Ut� / / ��yyt�iL / / <br /> Applicant Permitee Signature Date Issued By Si ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED B VE. <br />