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• CITY OF ORO O PERMIT NO.: 2011-01457 <br /> 2750 KELLEY PAR WAY <br /> ORONO, MN 553 6- DATE ISSUED: 1U2U2011 <br /> 952 249-4600 FAX: 95 249-4616 <br /> ADDRESS : 4440 BAYSIDE RD <br /> PIN : 31-118-23-34-0012 <br /> LEGAL DESC : PAINTERS CREEK <br /> : LOT O10 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : FIREPI,ACE-GAS <br /> VALUATION : $ 3,000.00 <br /> NOTE: 1 HEA"T N GLO ESCAPE I30 GAS FP <br /> APPLICANT MECHANI AL 50.00 <br /> FIRESIDE HEARTH& HOME STATE SU CHARGE MECH (VALUATION) 1.50 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN F E 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 53.50 <br /> OWNER <br /> MONTECALVO, DAVID&NICOLE <br /> 4440 BAYSIDE RD <br /> MAPLE PLA[N, MN 55359- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is�ssued shall be performed according to <br /> Ihe approved plans and specifications,applicable City approvals,and the <br /> Sta[e 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 /> pennrts. All provisions of laws and ordinanccs goveming this type of work <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if construction au[horized is not <br /> commenced within l80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter work has commenced. <br /> The applican[is responsible for assuring all required inspections are <br /> requested in conformance with tlie State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �"�ti1Gt-l-� Li�, l l l l <br /> Applicant Permitee Signature Date Issued y S� ature <br /> SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED AB E. <br />