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CITY OF ORONO * z 0 1 6 - 0 0 1 s 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/22/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1960 FOX RIDGE RD <br /> PIN : 03-117-23-13-0011 <br /> LEGAL DESC : FOX RIDGE <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,000.00 <br /> NOTE: GAS FIREPLACE(HEAT N'GLO) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 2.00 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 54.00 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#: mech-20512060 CHECK 00020054 54.00 <br /> OWNER <br /> STAUBER, ROB <br /> 1960 FOX RIDGE RD <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 Bui►ding Code.This permit may be <br /> revoked at any time for due cause. � <br /> � ( /� � � �� �� � � Z. <br /> r��� �t,� \ (J`�°``i Li'� ��� � �--L�----��� � � � <br /> I! <br /> Applicant Permitee Signature Date Issued By Signature Date <br />