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CITY OF OR NO PERMIT NO.: 2011-00564 <br /> ' 2750 KELLEY PA WAY <br /> ORONO, MN 55 56- DATE ISSUED: 06/30/2011 <br /> 952 249-4600 FAX: 9 2 249-4616 <br /> ADDRESS : 4355 BAYSIDE RD <br /> PIN : 06-117-23-12-0007 <br /> LEGAL DESC : LTNPLATTED 06 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�1 TYPE : FIREPLACE-GAS <br /> VALUATIOI�I : $ 2,250.00 <br /> NOTE: GAS FACTORY FIREPLACE <br /> APPLICANT MECHANI AL 50.00 <br /> MITTELSTAEDT INC <br /> P O BOX 454 STATE SU CHARGE MECH (VALUATION) 1.13 <br /> WATERTOWN, MN 55388- TOTAL 51.13 <br /> (612)716-9595 , <br /> Minnesota State License#: 20012394 <br /> OWNER <br /> WHITE, GREG&LYNN , <br /> 4355 BAYSIDE RD <br /> MAPLE PLAIN, MN 55359- � <br /> AGREEMENT AND SWORN STATEMENT I <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 I <br /> not grant permission for additional or rela[ed work which requires separa[e <br /> permi[s. AIl provisions of laws and ordinances governing[his type of work � <br /> shall be compied with whether or no[specified herein.This permit will � <br /> expire and become null and void if construction authorized is not I <br /> commenced within 180 days of the date of issuance,or if construction is i <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 Co�rfOrin�nce wrth State Building Code.This permit may be <br /> revoke "any tirrie� se. <br /> �� �� i <br /> - -,� �� l <br /> Appl-�c�f, a�inite�Si ature Date Issu B Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE THAN DESCRIBED ABOVE. <br />