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� � CITY OF ORONO PERMIT NO.: 2009-00855 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 1U30/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 175 CRYSTAL CREEK RD <br /> PIN : 33-118-23-33-0006 <br /> LEGAL DESC : CRYSTAL CREEK <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE- WOOD <br /> VALUATION : $ 1,500.00 <br /> NOTE: WOOD BURNING FIREPLACE-BRAND NAME-HEATILATOR <br /> APPLICANT MECHANICAL 50.00 <br /> INTEGR[TY DESIGN&CONSTRUCTION INC STATE SURCHARGE MECH(VALUAT[ON) 0.75 <br /> 21140 HONEYCOMB PATH TOTAL 50.75 <br /> LAKEVILLE, MN 55044- <br /> (952)985-5004 PAID WITH CC# 9899 <br /> Minnesota State License#: 20004064 <br /> OWNER <br /> ENGEBRETON,ANDREW& SALLY <br /> 175 CRYSTAL CREEK RD <br /> LONG LAKE, MN 55356 <br /> AGREEMENT A1vD SWORN STATEMENT <br /> Thc 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. Ali provisions of laws and ordinances govcrning this type of work <br /> shali 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 I 80 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 alI required inspections are <br /> q ested in conformance with the State Building Code.This permit may be <br /> o�ed at any[ime for due cause. <br /> --� 11 � 3� , D� � � <br /> Applicant P mitee Signature Date Issued E3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />