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J CITY OF ORONO <br /> * Z 0 1 5 - PJ 1 5 9 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/28/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 745 FERNDALE RD N <br /> PIN : 36-118-23-12-0007 <br /> LEGAL DESC : JANET ACRES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,500.00 <br /> NOTE: VERMONT CASTINGS GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.75 <br /> PRACTICAL SYSTEMS MAIL-IN FEE 2.00 <br /> 4342B SHADY OAK RD <br /> HOPK[NS,MN 55343 TOTAL 53.75 <br /> (952)933-1868 Payment(s) <br /> CHECK 8569 53.75 <br /> OWIYER <br /> FREY, KAREN <br /> 745 FERNDALE RD N <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 afrer work has commenced. <br /> The applicant is responsible for assuring aIl 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 /> � � � � J�, �,/5 <br /> /Y1r1� <br /> Applica �Permitee Signature � Date [s ued�B Signature Date <br />