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. ' CITY OF ORONO * 2 0 1 4 - 0 1 2 3 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2014 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2605 KELLY AVE <br /> PIN : 20-117-23-14-0022 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 005 BLOCK 005 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 10,000.00 <br /> NOTE: (2)HEAT N GLO FIREPLACES <br /> ROUGH-IN VENTING ONLY FOR A FUTURE FIREPLACE <br /> APPLICANT MECHANICAL 125.00 <br /> STATE SURCHARGE MECH(VALUATION) 5.00 <br /> GLOWING HEARTH AND HOME MAIL-IN FEE 2.00 <br /> 100 ELDORADO DRIVE TOTAL 132.00 <br /> JORDAN, MN 55352 <br /> (952)495-2927 Payment(s) <br /> CHECK 19761 132.00 <br /> OWNER <br /> WINE, SCOTT&JILL <br /> 2587 KELLY AVE <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permi[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 rype of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction au[horized 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 with[he State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � /D�a� � <br /> Applicant Permitee Signature Date Issue y Signature Dat� / / <br />