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►' ' CITY OF ORONO * Z 0 1 6 — 0 0 4 0 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/2U2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 155 GOLDEN VIEW DR <br /> PIN : 33-118-23-43-0014 <br /> LEGAL DESC : PETERMAN 2ND ADDN <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,000.00 <br /> NOTE: NEW GAS FIREPLACE(HEATILATOR) <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUAT[ON) 2.00 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 54.00 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CHECK 0002007C 54.00 <br /> OWNER <br /> SMITH,DOUGLAS <br /> 155 GOLDEN VIEW DR <br /> LONG LAKE,MN 55356 <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 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 l80 days of the date of issuance,or if construction is <br /> suspended for a period of l80 days at any time afrer 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 /> ��7 <br /> � �'����� � �y-�,l.�- �c�'�� ��—�s`��}-�s�, �-I � � I � I � <br /> Applicant Permitee Signature Date [ssued By Signature Date <br />