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� CITY OF ORONO <br /> ' " 2750 KELLEY PARKWAY * Z 0 1 3 - PJ 1 2 7 6 * <br /> DATE ISSUED: 12/09/2013 <br /> . ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3048 NORTH SHORE DR <br /> PIN : 09-117-23-32-0004 <br /> LEGAL DESC : CRYSTAL BAY PARK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 9,000.00 <br /> NOTE: HEAT N GLO SOOOC IPI 36000 BTU GAS FP <br /> HEAT N GLOF EXCLAIM 42T WOOD BURNING FP <br /> APPLICANT MECHANICAL 112.50 <br /> STATE SURCHARGE MECH(VALUATION) 4.50 <br /> FIRESIDE HEARTH& HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 TOTAL 119.00 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CHECK 2002902 119.00 <br /> OWNER <br /> KALLAS, KATHRYN D <br /> ]1653 CEDAR PASS <br /> HOPKINS,MN 55343- <br /> AGREEMENT A1VD 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 /> permits. 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 SO 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. <br /> \�V��il. l l <br /> Applicant Permitee Signature Date Issued B gnature Date <br />