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CITY OF ORONO * 2 0 1 6 — 0 1 5 0 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/02/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 100 BAYSIDE TR <br /> PIN : 06-117-23-22-0026 <br /> LEGAL DESC : BAYVIEW FARMS 2ND ADDN <br /> : LOT 1 BLOCK 1 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATIOI�I : $ 5,186.77 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECT[ON. <br /> HHT GAS FIREPLACF <br /> APPLICANT MECHANICAL 64.83 <br /> STATE SURCHARGE MECH(VALUATION) 2.59 <br /> FIRESIDE HEARTH& HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 69.42 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CREDIT CARD 4616 69.42 <br /> OWNER <br /> NORD, RANDAL <br /> 4420 HARBOR LA <br /> PLYMOUTH, MN 55441- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of I 80 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 /> � �-e �sv � �i a � l.� <br /> Applicant Perm ee Signature Da e ssued By nature Date <br />