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� CITY OF ORONO PERMIT NO.: 2011-01493 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 1U30/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2550 SIXTH AVE N <br /> P[N : 28-118-23-41-0005 <br /> LEGAL DESC : WILLOW RUN <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 800.00 <br /> APPLICANT MECHANICAL 50.00 <br /> MICHALS HHH, INC. STATE SURCHARGE MECH(VALUATION) 0.40 <br /> P.O. BOX 814 TOTAL 50.40 <br /> ANOKA, MN 55303 <br /> �) <br /> OWNER <br /> RICE, EDWARD&TERESA <br /> 2550 SIXTH AVE N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permik 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 additionai 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[ime after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in confor�nance with the State Building Code.This permit may be � <br /> revo d at n i f due cause. <br /> ����� -��--- //��G' � /�� ' �,-r,,�..x_�<� �/�:�� �/ <br /> � � <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />