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CITY OF ORONO PERMIT NO.: 200�-0009s <br /> 2750 KELLEY PARKWAY <br /> � ORONO,MN 55356- DATE ISSUED: 03/09/2009 <br /> r 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2680 SHADYWOOD RD <br /> PIN : 21-117-23-24-0046 <br /> LEGAL DESC : SHORE HILLS <br /> : LOT O15 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 14,145.00 <br /> NOTE: 4 GAS FACTORY FIREPLACES <br /> HEAT N GLO&HEATILATOR <br /> APPLICANT IvIECHANICAL 176.81 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 7.07 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 TOTAL 185.88 <br /> Minnesota State License#:20512060 <br /> OWNER <br /> SEWALL,BARRY <br /> 2680 SHADYWOOD RD <br /> EXCELSIOR,MN 55331- <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 Bailding Code. 1'his permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepuate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whe[her 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 confortnance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> //LGGGt� �/ l l <br /> / / <br /> Applicant Permitee Signature Date Issued B ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. <br />