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• E CITY OF ORONO * 2 8 1 5 — 0 0 7 4 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/10/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4174 HIGHWOOD RD <br /> PIN : 07-117-23-44-0026 <br /> LEGAL DESC : HIGHWOOD LAKE MTKA <br /> : LOT 032 BLOCK 000 <br /> PERMTT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $2,220.20 <br /> NOTE: 1 GAS FIREPLACE,HEAT N GLO#SL-SSOTR-JPI-E <br /> APPLICANT MECHAI�IICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATIOl� 1.11 <br /> FIRESIDE HEART'H&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 53.11 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4608 53.11 <br /> OWNER <br /> LUNDE,DAVE <br /> P O BOX 4551 <br /> ST PAUL,MN 55104 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perfortned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and dces <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 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 Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �-A. �--A-� � � � , lv , GS <br /> �, <br /> Applicant Permitee Signature Date Issued By ignature Date <br />