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CITY OF ORONO PERMIT NO.: 2009-00503 <br /> � 2750 KELLEY PARKWAY <br /> . ORONO, MN 55356- DATE ISSUEv: 08/18/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3580 FREDERICK ST <br /> PIN : 20-117-23-12-0019 <br /> LEGAL DESC : NAVARRE <br /> : LOT 000 BLOCK 002 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,000.00 <br /> NOTE: 1 KOZY HEAT GAS FIREPLACE INSERT <br /> APPLICANT <br /> MECHANiCAL 50.00 <br /> WALTER MECHANICAL, INC. STATE SURCHARGE MECH VALUATION 1.00 <br /> 1169 E.CLIFF ROAD � � <br /> BURNSVILLE, MN 55337 MAIL-IN FEE 2.00 <br /> (952)895-1992 MISC FEE 0.00 <br /> TOTAL 53.00 <br /> OWNER <br /> NEWTON, LAVAY <br /> 3580 FREDERICK ST <br /> WAYZATA, MN 55391 <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 Buiiding Code. "I'his permit is for only the work described and does <br /> not grant permission for additional or related work which requices 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 aze <br /> reques[ed in conformance with the State Building Code.This permit may be <br /> revoked at any time fer due dause. <br /> / ��-(.� �. / / / / <br /> Applicant Permitee Signature Date Issued By gnature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />