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. <br /> CITY OF ORONO PERMIT NO.: 2012-00040 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE �ssuEu: OU17/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1685 FOX ST <br /> PI IV : 03-117-23-44-0004 <br /> LEGAL DESC : HANSER ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,000.00 <br /> NOTE: I HEAT N GLO ESCAPE 36 GAS FP <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 551 13 MAIL-IN FEE 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 54.00 <br /> OWNER <br /> HORNIG, STEVEN <br /> 1685 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc��ork for��hich 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 separa[e <br /> permits. All provisions of laws and ordinances governing[his type of work <br /> shall be compied with���hether or no[specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 days of the date o1�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 inspec[ions are <br /> requested in conformance wi[h the State Building Code.This permit may be <br /> revoked at any time fo`�e. <br /> �y`."� � � ��'l�'-ti- i i <br /> Applica�t Permitee Signature Date Issued By S nature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />