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• CITY OF ORONO * 2 0 1 5 - 0 0 3 4 PJ * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/24/2015 <br /> ORONO, MN 55356- <br /> 952) 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 3926 CHERRY AVE <br /> PIN : 08-117-23-33-0019 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 000 BLOCK 004 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 10,100.00 <br /> NOTE: BOTkI GAS&WOOD FIRF,PLACES <br /> APPLICANT MECHANICAL 12625 <br /> STATE SURCHARGE MECH(VALUATION) 5.05 <br /> GLOWING HEARTH AND HOME MAIL-IN FEE 2.00 <br /> 100 ELDORADO DRIVE <br /> JORDAN, MN 55352 TOTAL 133.30 <br /> (952)495-2927 Payment(s) <br /> CHECK 20547 133.30 <br /> OW1vER <br /> WASHUTA, KENNETH <br /> 3926 CHERRY AVE <br /> MOLTND, MN 55364- <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 goveming this type of work <br /> shall be compied with whe[her 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 responsibie 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 /> , <br /> � �1C��� �7�-�--�- ��-� < �Yv1c��� � , .�- y, � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />