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� � CITY OF ORONO PERMIT NO.: 2009-00415 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 07/20/2009 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1500 BRACKETTS POINT RD <br /> PIN : 11-117-23-34-0001 <br /> LEGAL DESC : BRACKETTS POINT 2ND ADDITION <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,500.00 <br /> NOTE: 1 HET N GLO GAS FP 8000-CF-OAK IPI <br /> APPLICANT MECHANICAL 56.25 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 2.25 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 60.50 <br /> OWNER <br /> PADDOCK, BRUCE <br /> 920 SHADY LA <br /> WAYZATA, <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,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 goveming this type of work <br /> shall be compied with whether or not specified hecein.This permit will <br /> expire and become null and void if construc[ion 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 /> vl/l� �i/� l l l l <br /> Applicant Permitee Signature Date Issued By ' nature ate <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />