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� <br /> CITY OF ORONO * 2 0 1 2 — 0 0 2 9 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/18/2012 <br /> i ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3340 GRAHAM HILL RD <br /> PIN : OS-117-23-I1-0012 <br /> LEGAL DESC : GRAHAM HILL PRESERVE 2 <br /> : LOT 4 BLOCK 2 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 12,100.00 <br /> NOTE: HEAT N GLO ST 36'I'R-IPI <br /> HEAT N GLO RED 60 <br /> APPLICANT MECHANICAL 151.25 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 6.05 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN SSl l3 TOTAL 157.30 <br /> (651)633-2561 <br /> Minnesota State License#: 20512060 <br /> OWNER <br /> MCCARTY, LEROY&LISA <br /> 3340 GRAHAM HILL ROAD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according[o <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. "l�his 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 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 are <br /> requested in conformance wi[h the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> _�, lir.� � � i1 f� i l"7�-� i � <br /> A licant Permitee Signature Date Issued By Signa Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THA DESCRIBE ABOVE. <br />