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� ~ CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 4 - 0 1 1 1 4 * <br /> DATE ISSUED: 09/30/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 440 BIG ISLAND <br /> P[N : 23-117-23-32-0078 <br /> LEGAL DESC : BIG ISLAND <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : MECHANICAL(> $500) <br /> PROPFRTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE- WOOD <br /> VALUATION : $ 9,450.00 <br /> NOTE: WOOD BURNING FIRGPLACF,-HEAT-N-GLO <br /> APPLICANT MECHANICAL 118.13 <br /> STATE SURCHARGE MECH (VALUATION) 4.72 <br /> FIRESIDE HEARTH& HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE TOTAL 124.85 <br /> ROSEVILLE, MN 55113 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CREDIT CARD 4608 124.85 <br /> OWNER <br /> RE[MANN,JOHN&ALICE <br /> 21957 MINNETONKA BLVD#12 <br /> EXCELSIOR, MN 553�1- <br /> AGREEMENT AND SWORN STATEMENT <br /> 1-he�cork Yor which this pennit is issued shall be perlormed according to <br /> the approved plans and specilications,applicable City approvals,and thc <br /> State E3uilding 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.'Chis permit will <br /> c�pire and become null and void if eonstruction 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 after work has commenced. <br /> l�he applicant is responsible for assurin�all 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 /> �/� /� l i� i �� <br /> Appli ant Permitee igna Date Issue y Signature Datc <br />