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� � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * Z 0 1 7 - 0 PJ 9 7 7 * <br /> DATE ISSUED: 08/17/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1750 SHADYWOOD RD <br /> PIN : 17-117-23-21-0021 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 016 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,585.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> MENDOTA GAS FIREPLACE <br /> MODEL FV46-NAT.GAS <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.79 <br /> TWIN CITY FIREPLACE STONE CO INC <br /> 6521 CECILIA CIR MAIL-IN FEE 2.00 <br /> EDINA,MN 55439- TOTAL 53.79 <br /> (952)777-4125 Payment(s) <br /> Minnesota State License#:mech-MB682977 CREDIT CARD 5715 53.79 <br /> OWNER <br /> SHAW,GRETCHEN&LYLE <br /> 7001 KENESTON DR <br /> EDEN PRAIRIE,MN 55346- <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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �i;�(.�"�<��,�.1 ;L � �G � l � � l / / <br /> Applicant Permitee Signature Date Issued Bv Signature Date <br />