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CITY OF ORONO * Z 0 1 5 - 0 1 2 9 1 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 10/06/2015 <br /> � ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1340 FOX ST <br /> P[N : 02-117-23-31-0056 <br /> LEGAL DESC : MINNETONKA BLUFES <br /> : LOT MB BLOCK 14 <br /> PERM[T TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUAT[ON : $ 2,000.00 <br /> NOTE: 2 GAS FACTORY FIREPLACES(SUPERIOR) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.00 <br /> HAGEN F[REPLACE SOLUTIONS <br /> 435 FAIRVIEW AVE N TOTAL 51.00 <br /> UNIT 2 Payment(s) <br /> ST PAUL,MN 55104- CHECK 2357 51.00 <br /> (612)839-7595 <br /> Minnesota State License#: mech-MB680260 <br /> OWNER <br /> Chamberlain Capital LLC <br /> 11578 CHAMBERLAIN COURT <br /> EDEN PRAIRIE, MN 55344- <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 sepazate <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 cons[ruction 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. � / � J <br /> 1 ( <br /> �r��`5�.� ./`� �_ \ <br /> �p ,� ���,� ( � �_t�f �� r� I C� , ��, , 1 � <br /> Applicant Permitee Signature ate [ssued By Signature Date <br />