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CITY OF ORONO PERMIT NO.: 2010.00779 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUED: 09/16/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3205 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0011 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENT[AL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,125.00 <br /> NOTE: HEAT-N-G1,0 GAS FACTORY FIREYLACE-MODE L NO. -DAKO'1'A <br /> APPLICANT <br /> MECHAN]CAL 50.00 <br /> ANDERSON, RICHARD STATE SURCHARGE MECH (VALUATION) 5.00 <br /> 3205 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- TOTAL 55.00 <br /> OWNER <br /> ANDERSON, RICHARD <br /> 3205 CRYSTAL BAY 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 /> [he approved plans and specifications,applicable City approvals,and the <br /> State Building 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 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 /> r�quested in conforman wi the State Building Code.This permit may be <br /> rev � d at any time f du ause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />