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' � , CITY OF ORONO * z 0 1 4 - 0 0 3 1 6 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 04/17/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1065 FERNDALE RD W <br /> PIN : 02-117-23-43-0021 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1372 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,000.00 <br /> NOTE: 1 MENDOTA FV41 GAS FP <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.50 <br /> TWIN CITY FIREPLACE CO. MAIL-IN FEE 2.00 <br /> 6916 WASHBURN AVE. S. TOTAL 53.50 <br /> MINNEAPOLIS,MN 55423- <br /> (612)282-2684 Payment(s) <br /> CHECK 200349 53.50 <br /> OWNER <br /> DETOR,ELIZABETH&LUCAS <br /> 1065 FERNDALE RD W <br /> WAYZATA,MN 55391- <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 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 due cause. <br /> �� / / <br /> Applicant Permitee Signature Date Issued By Si ture Date <br />