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CITY OF ORONO PERMIT NO.: 20��-00624 <br /> , 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEn: 08/12/2011 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3980 CHERRY AVE <br /> PIN : 08-117-23-33-0026 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 000 BLOCK 005 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,186.00 <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 1.59 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 53.59 <br /> OWNER PAID WITH CC# 4978 <br /> SCHULTZ, KEVIN <br /> 5620 GIRARD AVE N <br /> MINNEAPOLIS, MN 55430- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and bewme nuli and void if construction authorized is not <br /> commenced within 180 days of[he 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 c�ause. <br /> �iYK.�L- �' l l _ l l <br /> Applicant Permitee Signature Date Issned By gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />