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CITY OF ORONO * z 0 1 5 - 0 1 1 0 2 * <br /> " 2750 KELLEY PARKWAY DATE ISSUED: 08/3U2015 <br /> � � ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 517 FERNDALE RD N <br /> PIN : 36-118-23-14-0007 <br /> LEGAL DESC : LJNPLATTED 36 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMTT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 12,000.00 <br /> NOTE: 3 GAS FIREPLACES& 1 WOOD FIREPLACE <br /> APPLICANT MECHANICAL 150.00 <br /> STATE SURCHARGE MECH(VALUATION) 6.00 <br /> TWIN CITY FIREPLACE STONE CO INC TOTAL 156.00 <br /> 6521 CECILIA CIR <br /> EDINA,MN 55439- Payment(s) <br /> (952)941-2685 CHECK 201746 156.00 <br /> Minnesota State License#:mech-MB682977 <br /> OWNER <br /> BURNET,RALPH&PEGGY <br /> 392 FERNDALE RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfortned 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 dces <br /> not grant permission for additional or related work which requires sepazate <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 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 confortnance with the State Building Code.This permit may be (1� <br /> revoked at any time for due cause. .,� 8G� � <br /> � �.� �-4 �� �� 3i � <br /> Applicant Permitee igna re Date Issued By Signature Date <br />