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, CITY OF ORONO PERMIT NO.: 2010-00641 <br /> , 2750 KELLEY PARKWAY <br /> ", ORONO, MN 55356- �ATE ISSUE�: 07/29/2010 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 515 FERNDALE RD N <br /> PIN : 36-118-23-14-0006 <br /> LEGAL DESC : UNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 12,000.00 <br /> NOTE: GAS FACTORY FIREPLACE-HEAT&GLO(4)ESCAPE-42DV <br /> APPLICANT MECHANICAL 150.00 <br /> GLOWING HEARTH AND HOME STATE SURCHARGE MECH (VALUATION) 6.00 <br /> 100 ELDORADO DRIVE <br /> JORDAN, MN 55352 MAIL-IN FEE 2.00 <br /> (952)495-2927 MISC FEE 0.00 <br /> TOTAL 158.00 <br /> OWNER <br /> GRIFFIN, ROBERT <br /> 125 CHEVY CHASE DR <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 specitications,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 cequires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or no[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(80 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 /> Applicant Permitee Signature Date Issued By S� nature " <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . <br />