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� CITY OF ORONO PERM[T NO.: 2008-00376 <br /> ' 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 1U10/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 35 CRYSTAL CREEK RD <br /> PIN : 33-118-23-33-0002 <br /> LEGAL DESC : CRYSTAL CREEK <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RES[DENT[AL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,478.00 <br /> APPLICAIYT MECHAN[CAL 43.48 <br /> STATEWIDE GAS SERVICES STATE SURCHARGE MECH(VALUATION) 1.74 <br /> 201 WEST MAIN <br /> MN 55387- MAIL-[N FEE 1.50 <br /> (952)447-7185 M[SC FEE 0.00 <br /> TOTAL 46J2 <br /> OWNER <br /> KOEHLER, STEVEN& ANNE <br /> 35 CRYSTAL CREEK RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approvcd plans and specifications,applicable City approvals,and the <br /> State I3uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or relatcd 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 180 days orthe 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 /> / / / / <br /> Applicant Permitee Signature Date Issued I3y Si ature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />