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CITY OF ORONO PERMIT NO.: 2010-00118 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 03/03/2010 <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 420 ORCHARD PARK RD <br /> PIN : 32-118-23-23-0006 <br /> LEGAL DESC : ORCHARD PARK <br /> : LOT 008 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,500.00 <br /> NOTE: HEATALATOR NOVUS 33 GAS FP <br /> APPLICANT <br /> MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 0.75 <br /> 2700 FAIRVIEW AVE TOTAL 50.75 <br /> ROSEVILLE,MN 55113 <br /> (651)633-2561 <br /> Minnesota State License#:20512060 <br /> OWNER <br /> PETERSON,WILLIAM&LYNAE <br /> 420 ORCHARD PARK RD <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 /> 313 lio <br /> Applicant Pe ee Signature Date Issued By ill ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABOV <br />