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CITY OF ORONO PERMIT NO.: 2011-00403 <br /> . 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE tSSU�n: OS/3U2011 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3215 GRAHAM HILL RD <br /> PIN : OS-117-23-14-0066 <br /> LEGAL DESC : GRAHAM HILL PRESERVE <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE ; MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,000.00 <br /> NOTE: HET N GLO 6000C-IPI <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH & HOME STATE SURCHARGE MECH (VALUATION) 1.00 <br /> 2700 FA[RVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 MISC FEE 0.00 <br /> Minnesota State License#: 20512060 TOTAL 53.00 <br /> OWNER <br /> KORSI, KEiTH& AMY <br /> 769 BOULDER DRIVE <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for�vhich this permit is issued shall be performed according[o <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 /> no[grant permission for additional or related work which requires separate <br /> pennits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specitied herein."rhis permit will <br /> expire and become null and void if construction authorized is not <br /> commenced with�n 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time atter work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Buiiding Code.This permit may be <br /> revoked at any time for due cause. <br /> `y�� � / / � <br /> Applicant Permitee Signature Date Issued By gnature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED ABO <br />