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CITY OF ORONO PERMIT NO.: 2011-00177 <br /> . 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE ISSUEn: 03/25/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> , ADDRESS : 2256 SHADYWOOD RD <br /> s PIN : 17-117-23-43-0125 <br /> ` LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 006 BLOCK 001 <br /> ! PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 7,000.00 <br /> NOTE: 2 HEAT N GLO GAS FIREPLACES <br /> APPLICANT MECHANICAL 87.50 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#:20512060 TOTAL 94.50 <br /> OWNER <br /> ' BURKE,FORREST&RENEE <br /> 2256 SHADYWOOD RD <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 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 aRer 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 /> � �L[f.(� �. � � / / <br /> '_",Applican Permitee ignature Date Issued By ' nature ate <br /> � _ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br /> s <br /> + ; <br />