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CITY OF ORONO * 2 B 1 3 - 0 � 7 8 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/12/2013 , <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 4395 NORTH SHORE DR <br /> PIN : 07-117-23-43-0018 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 000 BLOCK 018 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,000.00 <br /> NOTE: HEAT N GLO 6000 CL IPI <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 1.50 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 TOTAL 53.50 <br /> Minnesota State License#:20512060 <br /> OWNER <br /> CORNESS,JOHN&BARBARA <br /> 4395 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 City approvals,and the <br /> State Building Code. This petmit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for duacause. <br /> ��'�'�'� �l' / / / / <br /> Applicant Permitee Signature Date Issue By ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABO . <br />