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CITY OF ORONO II 111FHIH <br /> * <br /> 2750 KELLEY PARKWAY <br /> * 21 8 - 0 0 2 <br /> DATE ISSUED: 04/11 1/22 018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 200 BEDERWOOD DR <br /> PIN : 05-117-23-12-0027 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.203 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,200.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> KOZY HEAT-SLAYTON 36-GAS FIREPLACE INSTALL ONLY <br /> GASLNE BY OTHERS <br /> APPLICANT MECHANICAL 52.50 <br /> WACONIA COMFORT STATE SURCHARGE MECH(VALUATION) 2.10 <br /> 201 W MAIN STREET MAIL-IN FEE 2.00 <br /> WACONIA,MN 55387- TOTAL 56.60 <br /> (952)442-3473 Payment(s) <br /> Minnesota State License#:mech-MB003544 CREDIT CARD 5162 56.60 <br /> OWNER <br /> AZAD,ALISHAH <br /> 200 BEDERWOOD DR <br /> LONG LAKE,MN 55356- <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 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 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 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 /> it,C6 ,'10 t.) A-G-IS'r0i )/ i/ r <br /> Applicant Permitee Signature Date Issued By Si ature Date <br />