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CITY OF ORONO * 2 0 1 7 — 0 0 5 3 3 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 05/22/2017 <br /> ' ORONO,MN 55356— <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3295 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0013 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 8,209.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> NEW:GAS FACTORY FIREPLACE(HHT) <br /> APPLICANT MECHANICAL 102.61 <br /> STATE SURCHARGE MECH(VALUATION) 4.10 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 108.71 <br /> (651)63�2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 108.71 <br /> OWNER <br /> GREG BLASKO&WHITNEY WINDMILLER <br /> 3295 CRYSTAL BAY 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 Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and dces <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. f�"� <br /> ( �1,�� �� C�CDC.ScJ1 /�..-�.0 7�C.� �j� ZZf l <br /> Applicant Permitee Signature Date Issued By Signature Date <br />