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, . � CITY OF ORONO PERMIT NO.: 2009-00360 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUE�: 06/29/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2640 FOX ST <br /> PIN : 04-117-23-42-0008 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1249 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�I TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,310.00 <br /> NOTG: <br /> GAS FACTORY FIREPLACE-MAJESTIC-MODEL NO. 500 DVMLNV <br /> APPLICANT <br /> MECHANICAL 50.00 <br /> AUTOMATIC GARAGE DOOR&FIREPLACE STATE SURCHARGE MECH (VALUATION) 1.16 <br /> 8900-109TH AVE N -#1000 <br /> CHAMPLIN, MN 55316 TOTAL 51.16 <br /> (763)571-2525 <br /> Minnesota State License#: 1990 <br /> OWNER <br /> WESTLING, TOM <br /> 2640 FOX ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permit is issued shall be performed according to <br /> the approvcd plans and specifications,applicable City approvals,and the <br /> State Building Code. This permi[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 /> shaii be compied with whether or not specified herein.This permit wiil <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 /> e kcd at any time for due cause. <br /> `� 'Z�� � �'l ��� ,� '% / Q� � <br /> Applicant Permitee Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK HER THAN DESCRIBED ABOVE. <br />