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w• <br /> CITY OF ORONO PERMIT IVO.: 2009-00815 <br /> � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- nATE IssUEn: 1U12/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3235 GRAHAM HILL RD <br /> PIN : OS-117-23-14-0068 <br /> LEGAL DESC : GRAHAM HILL PRESERVE <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-WOOD <br /> VALUATION : $ 11,000.00 <br /> NOTE: <br /> (1)GAS FACTORY GASLOG-I IEAT-N-GLO-VWL-24 <br /> (2)WOOD BURNING FIREPLACES-HEAT-N-GLO-RUT[IER}'ORD 50 AND EXCLAIM 36 <br /> APPLICANT <br /> MECHANICAL 137.50 <br /> FIRESIDE HEARTH & HOME STATE SURCHARGE MECH(VALUATION) 5.50 <br /> 2700 FA[RVIEW AVE <br /> ROSEVILLE, MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 TOTAL 145.00 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> KILL, BOB&COURTNEY <br /> 350 NORTH ARM LANE <br /> MOUND, MN 55364- <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 specitied herein.This permit will <br /> expire and become null and void if construction authorized is no[ <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days a[any time after work has conunenced. <br /> The applicant is responsible for assuring all required inspec[ions are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at afry time for due cause. <br /> ����ZGz.�� /�l /�-1- O� //l / l D <br /> Applicant Permitee Signature Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRBED ABOVE. <br />