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' � CITYOFORONO * Z016 - 0PJ737 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/23/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4220 CHIPPEWA LA <br /> PIN : 31-118-23-42-0012 <br /> LEGAL DESC : CHIPPEWA 2ND ADDN <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIY TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,700.00 <br /> NOTF,: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> (3)GAS FIREPLACES <br /> APPLICANT MECHAN[CAL 58.75 <br /> STATE SURCHARGE MECH(VALUATION) 235 <br /> GLOWING HEARTH AND HOME MAIL-IN FEE 2.00 <br /> 100 ELDORADO DRIVE <br /> JORDAN, MN 55352 TOTAL 63.10 <br /> (952)495-2927 Payment(s) <br /> CHECK 23196 63.10 <br /> OWNER <br /> DBG, LLC <br /> SCHRODER,SUSAN <br /> 4725 WEST LANE <br /> MINNETRISTA, MN 55364- <br /> AGREEMENT A1vD SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the 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 specified 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 /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �� �O l�L.J l �C� <br /> Applicant Permitee Signature Date ssued B ignature Date <br />