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. � CITY OF ORONO PERMIT NO.: 20o9-oos�2 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 12/03/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 139 CHEVY CHASE DR <br /> PIN : 36-ll 8-23-41-0025 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 020 BLOCK 001 <br /> PERMIT TYPE : MECHAN[CAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,000.00 <br /> N01'E: GAS FIREPLACE-TRAVID-MODEL NO.98400108 <br /> APPLICANT MECHANICAL 50.00 <br /> PRACTICAL SYSTEMS STATE SURCHARGE MECH (VALUATION) 1.00 <br /> 4342 B SHADY OAK RD <br /> HOPKINS, MN 55343 TOTAL 51.00 <br /> (952)933-1868 <br /> OWNER <br /> BELTRAND, MR.& MRS. <br /> 139 CHEVY CHASE DR <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall be perlormed according to <br /> [he 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 specitied herein.This permit will <br /> expirc and become null and void if construction authorized is not <br /> commenced�vithin 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 Bui�ing Code.This permit may be <br /> revoRed at any time for due cause. r <br /> � : ---\) �.. � <br /> ��...._.�_.r •\ ,� r. ..:-7-.'a..._o`.. .r`'`,`�/ � l�' C, l l <br /> A�pplican't�mitee Signature Date ss e y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />