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4 ti CITY OF ORONO PERMIT NO.: 2010-01115 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEn: 1U15/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3225 CARMAN RD <br /> PIN : 20-]17-23-14-0009 <br /> LEGAL DESC : CARMAN COVE <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,200.00 <br /> NOTE: 1 HEAT N GLO ESCAPE 135FB GAS FP <br /> APPL1CAlYT MECHANICAL 50.00 <br /> FIRESIDE HEARTH & HOME STATE SURCHARGE MECH(VALUAT[ON) 5.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (65l)633-2561 M[SC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 57.00 <br /> PAID WITH CASH 3.40 <br /> OWNER <br /> HOUCK, BILL& MARY PAID WITH CC# 2216 <br /> 3225 CARMAN RD <br /> EXCELSIOR, MN 55331- <br /> AGREEMEI�T AI�D SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specilications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not gran[permission for additional or relatcd 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 specitied hereia 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 wifh the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> `;��C�l� � / / / / <br /> Applicant Permitee Signature Date Issued B ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />