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111111111111111111111111111101 <br /> CITY OF ORONO * 2 0 1 5 - 0 0 7 0 S * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/03/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 3750 NORTHERN AVE <br /> PIN 17-117-23-34-0087 <br /> LEGAL DESC REG. LAND SURVEY NO.0763 <br /> LOT 1 BLOCK I <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,500.00 <br /> NOTE: MONTIGO GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.75 <br /> TWIN CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00 <br /> 6521 CECILIA CIR <br /> TOTAL 53.75 <br /> EDINA,MN 55439- <br /> Payment(s) <br /> (952)941-2685 <br /> CHECK 201502 53.75 <br /> Minnesota State License#:mech-MB682977 <br /> OWNER <br /> NESS,COLLEEN <br /> 3750 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 /> 1 oft <br /> 1�CU <br /> Applicant Permitee Signature Date Issued By�,tgnature Date <br />