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, , CITY OF ORONO * z 0 1 3 - P1 0 PJ Z 6 * <br /> 2750 KELLEY PARKWAY �ATE �SSUED: OU1U2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3520 NORTH SHORE DR <br /> PIN : 08-117-23-43-0009 <br /> LEGAL DESC : BALDUR PARK <br /> : LOT 003 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�ISTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,500.00 <br /> NOTE: GAS FACTORY FIREPLACE-MODEL-SL-7�0"I'R-[PI <br /> 30,000 BTU <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH(VALUATION) OJS <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 TOTAL 50.75 <br /> (651)633-2561 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> PETERS ET AL,ANN L <br /> 3520 NORTH SHORE DR <br /> , MN 55391- <br /> AGREEMENT AND SWORIV STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approvcd 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 separatc <br /> permits. All provisions of laws and ordinances governing this type of�work <br /> shall be compied with whether or not specified herein.'1'his pern�it 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 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 /> ���'���� i l� i �3 � <br /> Applicant Permitee Signature � Date Issue By Signature �Dat� � � <br /> SEPARATE PERMITS REQUIRED FOR WORK O HER THAN DESCRIBED ABOVE. <br />