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1111111111111111 IN EI 1111 IN IN 11H Iffn <br /> CITY OF ORONO * 2015 - 00706 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/03/2015 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3740 NORTHERN AVE <br /> PIN : 17-117-23-34-0088 <br /> LEGAL DESC : REG.LAND SURVEY NO. 0763 <br /> LOT 2 BLOCK 1 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 800.00 <br /> NOTE: IHP BRAND FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.40 <br /> TWIN CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00 <br /> 6521 CECILIA CIR <br /> EDINA,MN 55439- TOTAL 52.40 <br /> Payment(s) <br /> (952)941-2685 <br /> CHECK 201502 52.40 <br /> Minnesota State License#:mech-MB682977 <br /> OWNER <br /> HOLMERS,TODD <br /> 3740 NORTHERN AVE <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 governing 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 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 /> 12 <br /> mil- <br /> �n l 1j l •S <br /> Applicant Permitee Signature Date Issued By Signature Date <br />