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, , , CITY OF ORONO PERMIT NO.: 2009-00003 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE �ssuEn: OU05/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4060 DAHL RD <br /> PIN : 07-117-23-1]-0020 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT 016 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHAN[CAL-MULTIPLE <br /> VALUATION : $ 1,665.00 <br /> APPLICANT MECHANICAL 35.00 <br /> FIRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 0.83 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 TOTAL 35.83 <br /> (651)633-2561 <br /> Minnesota State License#: 20512060 <br /> OWIVER <br /> NEVE, MR&MRS. JAMES <br /> 4060 DAHL RD <br /> MOiIND, MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this pennit 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 rcquires separate <br /> permits. All provisions of laws and ordinances goveming 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 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 permit may be ��� <br /> revoked at any ti ne for due cause. , <br /> ; ,�'���..R, ( l 5 / (3� ` � �� � C �`Y1�ce r � / -_� �9 <br /> Appficant Pcrmite Si nalure Date Issued I3y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />