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` CITY OF ORONO PERMIT NO.: 2009-00740 <br /> r 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEu: 10/20/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1880 FOX ST <br /> PIN : 03-117-23-42-OO15 <br /> LEGAL DESC : WALDRON WOODS <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,525.00 <br /> NOTE: 2 HEAT N GLO GAS FIREPLACES <br /> APPLICANT MECHANICAL 50.00 <br /> GLOWING HEARTH AND HOME STATE SURCHARGE MECH(VALUATION) 1.76 <br /> 100 ELDORADO DRIVE <br /> JORDAN, MN 55352 MAIL-IN FEE 2.00 <br /> (952)495-2927 MISC FEE 0.00 <br /> TOTAL 53.76 <br /> OWNER <br /> BLUM, STEVEN& DEBORAH <br /> 1880 FOX STREET <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 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 requices separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shali 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 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with t,(�e State Building Code.This permit may be <br /> revoked at any time fol due cause. <br /> �'�'I'L� (.�. / / / / <br /> Applicant Permitee Signature Date Issued By nature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />