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, +� CITY OF ORONO ''`2014-00933X <br /> < t <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/2U2014 <br /> ' ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1 161 ELMWOOD AVE <br /> PIN : 07-117-23-14-0029 <br /> LEGAL DESC : SKARP& LINDQU[STS FERNHILL LA <br /> : LOT 009 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,000.00 <br /> NOTE: l GAS FIREPLACE(MENDOTA) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 2.00 <br /> TW[N CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00 <br /> 6521 CECILIA CIR <br /> EDINA, MN 55439- TOTAL 54.00 <br /> (952)941-2685 Payment(s) <br /> Minnesota State License#:mech-MB682977 CHECK 200631 54.00 <br /> OWNER <br /> SUNDBERG, RICHARD <br /> 5125 WEST STREET <br /> GREENWOOD, MN 55331- <br /> AGREEMEIVT AND SWORN STATEMENT <br /> Che work for which this permit is issued shall be performed according to <br /> thc 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 typc 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 wi[hin 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 anv time for dae cause. <br /> _ � � �{ ( <br /> Applicant Pe itee ignature Date Issu d y Signature Date <br /> I <br />