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� � ' CITY OF ORONO PERMIT NO.: 2009-oo�s� <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/27/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1169 NORTH ARM DR <br /> PIN : 07-117-23-14-0060 <br /> LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,500.00 <br /> NOTE: GAS FACTORY FIREPLACE-BRAND NAME: HEAT-N-GLO,MODEL NO: FBIN <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 1.75 <br /> 2700 FAIRVIEW AVE TOTAL 51.75 <br /> ROSEVILLE,MN 55113 <br /> (651)633-2561 <br /> Minnesota State License#:20512060 <br /> OWNER <br /> ALNESS,RYAN <br /> 1169 NORTH ARM DR <br /> MOUND,MN 55364 <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 separate <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 construction authorized is not <br /> commenced within I 80 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> i�=� �v �a� ��� !� D� oZ� � <br /> Applicant Permitee Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />