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� CITY OF ORONO * 2 0 1 6 — 0 0 6 6 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/08/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 102 CHEVY CHASE DR <br /> P[N : 36-118-23-41-0031 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 026 BLOCK 001 <br /> PERMIT TYPE : MECHAN[CAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,516.75 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> REPLACE: 1 GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.76 <br /> FIRESIDE HEARTH&HOME MA[L-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 53J6 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4608 53.76 <br /> OWNER <br /> NELSON, MICHAEL&KATHY <br /> 102 CHEVY CHASE DR <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 specifications,applicable Ciry approvals,and the <br /> State Building Code. This permit is for only Ihe work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I80 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 a►I 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 /> I ��`� i c"' L�4,� <br /> ���c� c;�;� +�cc�� � ;� � jk. <br /> Applicant Permitee Signature Date Issued By Signature Date <br />