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CITY OF ORONO 1111111 IN pill ®11111M <br /> 2750 KELLEY PARKWAY * 2 1 5 - P 0 5 0 <br /> DATE <br /> E ISSUED:: 05/07/22 015 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS 3035 CASCO POINT RD <br /> PIN 20-117-23-34-0001 <br /> LEGAL DESC REG.LAND SURVEY NO.0394 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 5,902.60 <br /> NOTE: GAS FIREPLACE HEAT-N-GLO CERONA36 <br /> APPLICANT MECHANICAL 73,78 <br /> FIRESIDE HEARTH&HOME <br /> STATE SURCHARGE MECH(VALUATION) 2.95 2700 FAIRVIEW AVE MAIL-IN FEE 2.00TOTAL 78.73 <br /> ROSEVILLE,MN 55113 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4608 78,73 <br /> OWNER <br /> HULBERT,JAY <br /> 3035 CASCO POINT RD <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 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 for due cause. <br /> Applicant Permitee Signature Date Issued y Signature Date <br />