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, � <br /> CITY OF ORONO PERMIT NO.: 2011-01587 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 12/29/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1100 MILLSTON RD <br /> PIN : 10-117-23-14-0015 <br /> LEGAL DESC : MILLSTON <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-WOOD <br /> VALUATION : $ 19,300.00 <br /> NOTE: WOOD BURNING FIREPLACE <br /> APPLICANT MECHANICAL 241.25 <br /> STONWERK STATE SURCHARGE MECH(VALUATION) 9.65 <br /> 2434 COMMERCE BLVD TOTAL 250.90 <br /> MOUND,MN 55364- <br /> (952)472-0714 PAID WITH CC# 3737 <br /> Minnesota State License#: BC323192 <br /> OWNER <br /> BURWELL,MR.&MRS. RODNEY P <br /> 7901 XERXES AVE S <br /> BLOOMINGTON,MN 55431- <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 for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <br /> pertnits. All provisions of laws and ordinances goveming 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 consVuction authorized is not <br /> commenced within 180 days of the date of issuance,or if consWction 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. <br /> ` fz l l �/ � /Zy Z��� � <br /> Applicant Permitee ature Date Iss e y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />