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. <br /> CITY OF ORONO PERMIT NO.: 2010-00522 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE [SSUE�: 06/24/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1785 CONCORDIA ST <br /> PIN : 17-117-23-22-0016 <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-WOOD <br /> VALUATION : $ 3,197.00 <br /> NOTE: WOOD BURNING FIREPLACE-MAJESTIC-MODEL#ODSR36A <br /> APPLICAI�IT MECHANICAL 50.00 <br /> AUTOMATIC GARAGE DOOR& F[REPLACE STATE SURCHARGE MECH(VALUATION) 1.60 <br /> 8900 109TH AVE N <br /> SUITE 1000 TOTAL 51.60 <br /> CHAMPLIN, MN 55316 <br /> (763)571-2525 <br /> OWNER <br /> DULIN, KEVIN & BARBARA <br /> 1785 CONCORD[A ST <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 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 separa[e <br /> permits. All provisions oY laws and ordinances governing this type of work <br /> shall be compied wi[h whether or no[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 after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State E3uilding Code.This permit may be <br /> revoked at any time for due cause. <br /> �� G� � �y� i o ����[,/c_- l� J� /o <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />