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' ` CITY OF ORONO * Z 0 1 5 - 0 0 2 9 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/12/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3399 CRYSTAL BAY RD <br /> pIN : 17-117-23-44-0021 <br /> LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B <br /> : LOT 018 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,500.00 <br /> NOTE: TRAVIS GAS FACTORY FIREPLACE-MODEL#98500193 <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.25 <br /> PRACTICAL SYSTEMS MAIL-IN FEE 2.00 <br /> 4342B SHADY OAK RD <br /> HOPKINS,MN 55343 TOTAL 53.25 <br /> (952)933-1868 Payment(s) <br /> CREDIT CARD 5815 53.25 <br /> OWNER <br /> V MCKINNEY,STEVE SOBIENIAK/ <br /> 3399 CRYSTAL BAY RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORI�i 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 /> permiu. Ali 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 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> !�/1Q.L� �� /�j/� <br /> Applicant Permitee Signature ' Date Issued Signature Date <br />