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CITY OF ORONO PERMIT NO.: 2012-00035 <br /> � 2750 KELLEY PARKWAY <br /> . ORONO, MN 55356- �ATE [SSUEu: OU17/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2749 KELLY AVE <br /> PIN : 21-117-23-23-0027 <br /> LEGAL DESC : REG. LAND SURVEY NO.0891 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCT[ON TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,500.00 <br /> NOTE: KOZY HEAT FIREPLACE CSK-335-IPI <br /> APPLICANT MECHANICAL 50.00 <br /> PRACTICAL SYSTEMS STATE SURCHARGE MECH (VALUATION) 1.25 <br /> 4342 B SHADY OAK RD <br /> HOPKINS, MN 55343 TOTAL 51.25 <br /> (952)933-1868 <br /> OWNER <br /> TEARLE,CHAD& ELEANOR <br /> 2749 KELLY AVE <br /> EXCELSIOR, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permi[is issued shall be perlormed according to <br /> the approved plans and speeifications,applicable City approvals,and the <br /> State Buildin�Code. This permit is for only Ihe work described and does <br /> not grant permission for additional or rela[ed work which requires separate <br /> permi[s. 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 construc[ion 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 confonnance with the State Building Code.This permit may be <br /> n '' 7 <br /> revoked at any time for due cause. , l � <br /> < <br /> i6� <br /> . -;�-'.���,�., / i�� i/� �- � ! ; ("'�;���r'!�� � � � � /� <br /> Applicant[�ermite�Signature Date [ssued 13y Signature Date ��� <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />