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02%03/93 11:52 THE =IT( CIF ORONO 612-473-7357 003 <br />:"52-0-D <br />Wood stove with f vl <br />Wood combination cw add-on <br />Factory fireplace wrest flue <br />Factory Fireplace (s) <br />_ Wood Stove t <br />%ran_d Name Ifk(91;T4)-ISL _ <br />Mfgr's Min., Cleat ,rices. side W' ' <br />I•reestanding Masonry <br />Franklin, other <br />Model Nu <br />I _ Jr �. min. flue dia. F.S C).S. <br />- <br />vrr, rlON <br />Kitchen Exhau,i _ ducted _ rr,.:irculating _ __ cfm <br />Bath '-xbaust (ntoet he ducted ouWdc) cfm <br />0ther pang. I ocnom cfm <br />- T011N <br />EL'F.L �T(IN �cU, CMIJNF' yl- APPROVED BY F IRL• .NIARSHAL) <br />I•lswu.t%on Removal <br />�..._ Fuel oil gallons undergrouud inside .iutsitle <br />LP 035. _ Yallorts <br />()tber - -- -- V2 • n(eh111� <br />FERMI •s;s CAj-C U1—ATV`1ro <br />f (riltndct III I" or Nli11inium Fee (535.00)- <br />�:,ta <br />Add the State Building Cade Division S <br />St„cha,p.c to cath pL.•b .t. <br />P� _jhjije and Handling (Only mail -in applicatio'ts; _ lost., <br />J. TOTAL PERMIT FEE (Acid lines I• above) i � ,�=c <br />CONTRACT PRICE orJOB % 051 rnem, the atiu.tl ni estimated dollar am all <br />•+Ot.. In:hiding .ma.. salt. lab atttl (be[ fined wets It tr• !a•..ur. t ,c <br />later lb[ the w, •a dvtte I material. equipment, labor, or Instal .rst ac cse v -r, <br />..lnt or any ott. pari) flue !r. AMU mark,! n;ue of Such itrnu mu. °'V s-osl <br />vi contract price tor.prrmn 4 -. rrposes Iv'' :i.: that there N a di.puq. v .r ;n•. rst't}c jop, c..,:. <br />thu: t Ity may regttest the sunaussloa of a S[s.1% . ,opy Of the actual contra►+. <br />•' De S 1 ATE SURCHARGE Is .0003 (.. it contract price under St ,f)MAN) or S 50 - whichever is <br />gr•:urr 1.411 valuahons over SI,OoO,Wts call the Department of tnspecttonal serStces (m.. the price <br />he undersigned herehy applies 1!! the Cit.., for i'�Suarh:c of a M«11ntucal peuurt. agrees t. Ju <br />all w(16 it. lrici a, rordance with its 'tnetices of t;)e City ai o the regulations o: the 11in• -mxa <br />State Hut)duip arkl certifies t; .1 statements made • this application arc coinplete, true <br />crud Col. <br />'c <br />Arhl. aru: _ �1�J`L'\ T ? 3 �3_ <br />