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CITY OF ORONO <br /> f 2750 KELLEY PARKWAY * 2 PJ 1 4 - 0 PJ 0 1 4 * <br /> DATE ISSUED: O1/07/2014 <br /> r ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1937 FAGERNESS POINT RD <br /> PIN : 17-117-23-23-0012 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 020 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTiON TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,000.00 <br /> NOTE: HGn"C N GLO 5�0 METRO GAS FP <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 1.50 <br /> FIRESIDE HEARTH & HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 TOTAL 53.50 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CHECK 2003393 53.50 <br /> OWNER <br /> BOLDENOW, ELLIE <br /> 1937 FAGERNESS PT RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AIVD 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[3uilding 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 authorired is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of I AO days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the S[ate[3uilding Code.This permit may be <br /> revoked at any time for due cause. <br /> .����'t-'��L / / <br /> Applicant Permitee Signature Date Issucd By S nature Date <br />