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! <br /> ` CITY OF ORONO * Z 0 1 4 - 0 1 3 6 B * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1 U25/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3825 NORTH SHORE DR <br /> PIN : 17-117-23-22-0046 <br /> LEGAL DESC : SHERRI LAKEVIEW ESTATES <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,500.00 <br /> NOTE: MONTIGO GAS FACTORY FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.25 <br /> TWIN CITY FIREPLACE STONE CO INC MpIL-IN FEE 2.00 <br /> 6521 CECILIA CIR <br /> EDINA,MN 55439- TOTAL 53.25 <br /> (952)941-2685 Payment(s) <br /> Minnesota State License#:mech-MB682977 CHECK 200926 53.25 <br /> OWNER <br /> LANDSOUCE <br /> 3845 NORTH SHORE DR <br /> MOLJND, MN 55364- <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 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.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 /> // / d 5//J�-- <br /> Applicant Permitee Signatur Date Issue By Signature Date <br />