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MUIRMEMMM <br /> CITY OF ORONO * 2017 - 00793 * <br /> f 2750 KELLEY PARKWAY DATE ISSUED: 07/11/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)2494616 <br /> ADDRESS 540 WILLOW DR S <br /> PIN 03-117-23-32-0018 <br /> LEGAL DESC N/A <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-WOOD <br /> VALUATION : $ 2,000.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> WOOD BURNING FIREPLACE <br /> QUADRA FIRE-HEARTH&HOME <br /> MODEL NO.- EXCLAIM-42H <br /> APPLICANT MECHANICAL 50.00 <br /> GLOWING HEARTH AND HOME STATE SURCHARGE MECH(VALUATION) 1.00 <br /> 100 ELDORADO DRIVE MAIL-IN FEE 2.00 <br /> JORDAN,MN 55352 TOTAL 53.00 <br /> (952)495-2927 Payment(s) <br /> Minnesota State License#:mech-MB005786 CHECK 25297 53.00 <br /> OWNER <br /> BOHLANDER,LAURA <br /> 2260 FOX ST <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 /> ` 7/ <br /> Applicant Permitee Signature Date 4ssued ature Date <br />