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1111111111111111111111 MUM <br /> CITY OF ORONO * 2012 - <br /> Z01z - 00302 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/19/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 3035 CASCO POINT RD <br /> PIN 20-117-23-34-0001 <br /> LEGAL DESC REG. LAND SURVEY NO. 0394 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIREPLACE-GAS <br /> VALUATION $ 7,000.00 <br /> NOTE: (2)GAS FIREPLACES-HEAT-N-GLO-MODEL NO: SL750TRS/6000C <br /> APPLICANT MECHANICAL 87.50 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 3.50 <br /> 2700 FAIRVIEW AVE TOTAL 91.00 <br /> ROSEVILLE,MN 55113 <br /> (651)633-2561 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> TRIPP, DOUGLAS&PATRICIA <br /> 3035 CASCO POINT 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 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 /> '� /1,7 i 1;2- vim---- <br /> Applicant Pe�rmitee Signature Date *lssuBy Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />