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, , CITY OF ORONO * z 0 1 5 - 0 0 1 z 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU26/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 965 EDGEWOOD H[LLS RD <br /> PIN : 02-117-23-14-0001 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1098 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,150.00 <br /> NOTE: HEAT-N-GLO GAS FACTORY FIREPLACE-MODEL#800DC-TPI <br /> APPLICANT MECHANICAL 51.88 <br /> STATE SURCHARGE MECH(VALUATION) 2.08 <br /> FIRESIDE HEARTH& HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 TOTAL 55.96 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CREDIT CARD 4608 55.96 <br /> OWNER <br /> BJORK, ROBERT&BETH <br /> 965 EDGEWOOD HILLS 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 /> 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 /> expice 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 /> � <br /> / /�Zlo/ �S <br /> Applicant Permitee Signature Date ssue y Signature Date <br />