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" CITY OF ORONO PERMIT NO.: 200�-00509 <br /> 2750 KELLEY PARKWAY <br /> t ORONO,MN 55356- DATE ISSUED: 08/2U2009 <br /> 952 249-4600 FAX: 952 249-4616 � <br /> ADDRESS : 4064 NORTH SHORE DR <br /> PIN : 07-117-23-44-0085 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE ; MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,000.00 <br /> NOTE: MARTIN DVZH GAS FIREPLACE <br /> GAS LINE TO FIRE PLACE IN LIVING ROOM <br /> APPLICANT MECHANICAL 50.00 <br /> PHIPPS&JANET OBRIGEWITSCH,DAN STATE SURCHARGE MECH(VALUATIOl� 0.50 <br /> 4064 NORTH SHORE DR TOTAL 50.50 <br /> MOLJND,MN 55364 <br /> OWNER <br /> PHIPPS&JANET OBRIGEWITSCH,DAN <br /> 4064 NORTH SHORE DR <br /> MOiJND,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 dces <br /> not gant 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 conslruction 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 ti due cause. <br /> / <br /> / 2( / c� <br /> / / <br /> A 'cant Permitee Si a e Date Issue By ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTI�R N DESCRIBED VE. <br />