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� CITY OF ORONO * Z 0 1 7 - 0 0 2 3 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/13/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1729 FAGERNESS PO[NT RD <br /> PIN : 17-ll 7-23-22-0035 <br /> LEGAL DESC : MAPLEGATE INLET <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ ]0,925.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINnL[NSPGCTION. <br /> HHT GAS FACTORY FIREPLACE-(2) <br /> APPLICANT MECHAN[CAL 136.56 <br /> STATE SURCHARGE MECH(VALUATION) 5.46 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRV[EW AVE <br /> ROSEVILLE, MN 55113 TOTAL 144.02 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CREDIT CARD 4616 144.02 <br /> OWNER <br /> BIEKER, DAVID <br /> 1729 FAGERNESS PT 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 Duilding Code. This permit is for only the work described and does <br /> not grant permission Yor additional or related work which requires separate <br /> pennits. 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 construetion is <br /> suspended for a period of 180 days at any time afrer 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 /> , � <br /> � " � �-� > �� l 7 <br /> Applicant Permitee Signature � Date Issued Signature Date <br />