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, <br /> � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 5 - 0 1 2 0 2 * <br /> DATE ISSUED: 09/18/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4205 NORTH SHORE DR <br /> PIN : 07-117-23-43-0004 <br /> LEGAL DESC : ORCHARD BEACH <br /> : LOT 002 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-WOOD <br /> VALUATION : $ 4,000.00 <br /> NOTE: NEW WOOD BURNING FIREPLACE(HEAT N GLO) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUAT[ON) 2.00 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRV(EW AVE <br /> ROSEVILLE, MN 55113 TOTAL 54.00 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CHECK 2005348 54.00 <br /> OW1vER <br /> KOEHLER, TIMOTHY& DANIELLE <br /> 4205 NORTH SHORE DR <br /> MOUND, MN 55364- <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 onty 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 permi[will <br /> expice 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 perniit may be <br /> revoked at any time for due cause. �'�� �%�) <br /> r / �i �c� ��1...� ��= �;� 1��+�� `�, � .�; �`� <br /> Applicant Permitee Signature Date [ssued y Signat e Date <br />