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111111I ii iiiiiiiiiiiiiiiii <br /> CITY OF ORONO <br /> * 20 1 7 - 0 1 4 1 2 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/31/2017 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2607 WEST LAFAYETTE RD <br /> PIN : 21-117-23-21-0010 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1468 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 5,213.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> HHT GAS INSERT AND GASLINE <br /> MODEL COSMO-I 35 <br /> APPLICANT MECHANICAL 65.16 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 2.61 <br /> 2700 FAIRVIEW AVE MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 69.77 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 69.77 <br /> OWNER <br /> COON,M PRIDE&S <br /> 2607 WEST LAFAYETTE 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 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 /> ��t� ) / / l/ /7 <br /> Applicant Permitee�ignature Date Issued By S gnature Date <br />