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,- CITY OF ORONO PERMIT NO.: 2009-00002 <br /> 2750 KELLEY PARKWAY <br /> . ORONO, MN 55356- �ATE ISSUEn: OUO2/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4060 DAHL RD <br /> PIN : 07-117-23-I1-0020 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT 016 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,620.00 <br /> NOTE: 1 HEAT N GLO GAS FIREPLACE <br /> APPL[CANT MECHANICAL 57.75 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 2.31 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 551 13 MAIL-IN FEE 1.50 <br /> (651)6.i3-2561 TOTAL 61.56 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> NEVE, MR&MRS. JAMES <br /> 4060 DAHL RD <br /> MOUND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> �I�he work for which this permit is issued shall be perfornied according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State I3uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separatc <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified hereia This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within l80 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 pemiit may be <br /> revoked at any time for due cause. <br /> / / / / <br /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />