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CITY OF ORONO *2 0 1 3 - 0 PJ 2 0 1 * <br /> _ 2750 KELLEY PARKWAY DATE ISSUED: 03/26/2013 <br /> , ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1250 FRENCH CREEK DR <br /> PIN : 10-117-23-32-0013 <br /> LEGAL DESC : FRENCH CREEK <br /> : LOT 005 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUAT[ON : $ 4,000.00 <br /> NOTG: HGAT N GLO ESCAPE I35 <br /> APPLICANT MECHAN[CAL 50.00 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 TOTAL 54.00 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> DANIELSON, SCOTT& SHARI <br /> 1250 FRENCH CREEK DR <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 Y'or only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permi[s. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whe[her or not specified herein.This permit will <br /> expire and become null and void if construction authorized is no[ <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 w�th the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �� �� � � / / <br /> Applicant Permitee Signature Date Issued B ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />