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` �' CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 0 1 6 - 0 1 5 0 3 * <br /> DATE ISSUED: 12/02/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2503 KELLY AVE <br /> PIN : 20-117-23-12-0054 <br /> LEGAL DESC : KELLY COVE <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,299.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> HHT GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 1.65 <br /> 2700 FAIRVIEW AVE MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 53.65 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 53.65 <br /> OWNER <br /> REVOR,MARGENE <br /> 2503 KELLY AVE <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT A1vD 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 perrr►it 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 wil( <br /> expire and become null and void if construction authorized is not <br /> commenced within I80 days of the date of issuance,or if construction is <br /> suspended for a period of I80 days at any time after work has commenced. <br /> The applicant is responsible for assuring aIl 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 /> �� � / � ��� l`�2� a� /�o <br /> Applicant Permrtee Signature Date Issued By gnature Date <br />