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CITY OF ORONO _ <br /> 00733 * <br /> 2750 KELLEY PARKWAY * DANE ISSUED: 06109/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 825 WILLOW DR S <br /> PIN : 10-117-23-22-0001 <br /> LEGAL DESC : UNPLATTED 10 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIREPLACE-GAS <br /> VALUATION $ 7,865.00 <br /> NOTE: (2)GAS FIREPLACES <br /> BRAND HHT <br /> TRUE-36S AND CARODG361-B <br /> APPLICANT MECHANICAL 98.31 <br /> STATE SURCHARGE MECH(VALUATION) 3.93 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 104.24 <br /> Payment(s) <br /> (651)633-2561 <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4608 104.24 <br /> OWNER <br /> JAGLO,JEFF <br /> 16890 80TH PL N <br /> MAPLE GROVE,MN 55311- <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 /> Applicant Permitee Signature Date Issue Signature Date <br />