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,� .. CITY OF ORONO * Z 0 1 5 - 0 0 0 3 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU13/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3350 FOX ST <br /> PIN : OS-117-23-44-0008 <br /> LEGAL DESC : FULLERTON ESTATES <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE- WOOD <br /> VALUATION : $ 8,500.00 <br /> NOTG: WOOD I3URNING FIREPLACt: <br /> APPLICANT MECHANICAL 106.25 <br /> CHATEAU BRICK STATE SURCHARGE MECH (VALUATION) 4.25 <br /> 2450 150TH STREET TOTAL 110.50 <br /> SHAKOPEE, MN 55379- Payment(s) <br /> (612)860-0621 CHECK 17164 1 10.50 <br /> OWNER <br /> BIGOS,NANCY <br /> 3350 FOX ST <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMEIVT <br /> �fhe�cork for�chich this permit is issued shall be perfonned according to <br /> the approved plans and spccitications,applicable City approvals,and thc <br /> State Buildine Code. This permit is}or onl��ihe work describcd and docs <br /> not grant permission for additional or rclated H�ork which requires separate <br /> permits. All provisions of la���s and ordinances governing this typc of work <br /> shall be compied���ith���hether or not specified herein.'I�his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 davs of the date of issuance_or if construction is <br /> suspended for a period of 180 da��s at any time alter work I�as commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance���ith the State Building Code.This pennit may be <br /> revoked at am°time for due cause. <br /> jY �� �--- ; --� � -� -� � � ,i� ��� <br /> Applicant Permitee Signature Date Issu }�Signature Date <br />