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, CITY OF ORONO PERMIT NO.: 2010-01114 <br /> s 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 1 U15/2010 <br /> _ (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1465 FOX ST <br /> PIN : 02-117-23-33-0002 <br /> LEGAL DESC : UNPLATTED 02 1 17 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PRONERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,300.00 <br /> NO"Ck�: 1 1 II',A"1�N PLO GSDCAPE I30PB GAS FIREPLACF, <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 5.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 57.00 <br /> OWNER PAID WITH CC# 2216 <br /> BALMFORTH, COLIN M& I <br /> 1465 FOX ST <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work for which this permil is issucd shall bc performed according to <br /> the approved plans and specifcations,applicablc City approvals,and the <br /> State E3uilding Code. This permit is for only the work describcd 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 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 fo�duc c�Ause. <br /> �.���� v/�- / / l l <br /> Applicant Pennitee Signature Date Issued►3y gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />