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� { CITY OF ORONO * 2 0 1 5 - 0 1 2 5 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/29/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2560 KELLY AVE <br /> PIN : 20-117-23-11-0007 <br /> LEGAL DESC : REG.LAND SURVEY NO.0088 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,500.00 <br /> NOTE: NEW(HEAT N'GLO)GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.75 <br /> CARTER CUSTOM CONSTRUCTION&FP MpIL-IN FEE 2.00 <br /> 3276 FANUM ROAD#400 <br /> VADNAIS HEIGHTS,MN 55110- TOTAL 52.75 <br /> (651)653-0190 Payment(s) <br /> Minnesota State License#: CHECK 10019 52.75 <br /> mech-MB004750,BUIL-BC632066 <br /> OWNER <br /> International Ministerial Fellowshi <br /> P.O.BOX 100 <br /> NAVARRE,MN 55392- <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 dces <br /> not grant permission for additional or related work which requires sepazate <br /> permits. All provisions of laws and ordinances goveming 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 1 SO days of the date of issuance,or if conswction 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 aze <br /> requested in conformance with the State Building Code.This permit may be r/-, <br /> revoked at any time for due cause. �/ <br /> ,' �._-... <br /> ' ( (�-��� ���t_.:�..�`",�U g �7y � /� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />