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, � - CITY OF ORONO * 2 0 1 5 - 0 0 4 3 S * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/15/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3135 NORTH SHORE DR <br /> PIN : 09-117-23-32-0018 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1113 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 8,000.00 <br /> NOTE: HEAT N GLO FIREPLACE <br /> APPLICANT MECHANICAL 100.00 <br /> STATE SURCHARGE MECH(VALUATION) 4.00 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE TOTAL 106.00 <br /> ROSEVILLE,MN 55113 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CHECK 00020053 106.00 <br /> OWNER <br /> MARX,KELLY&MELODEE <br /> 3135 NORTH SHORE DR <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 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 /> 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 consuuction 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 /> Q,� ( 6�.�-- � E�i►'�.�-� �,- �(� /� � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />