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� <br /> CITY OF ORONO PERMIT NO.: 2009-00276 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEu: 06/03/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2640 KELLY AVE <br /> PIN : 20-117-23-14-0006 <br /> LEGAL DESC : APPLE HILL <br /> : LOT 008 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,800.00 <br /> NOTE: GAS FIREPLACE-BRAND-QUADRA FIRE-MODEL NO.-QV135FB <br /> APPLICANT <br /> MECHANICAL 50.00 <br /> FIRESIDE HEARTH& HOME STATE SURCHARGE MECH (VALUATION) 1.90 <br /> 2700 FAIRVIEW AVE TOTAL 51.90 <br /> ROSEVILLE, MN 55113 <br /> (651)633-2561 <br /> Minnesota State License#:20512060 <br /> OWNER <br /> VOLKMAR,JOHN& SHERRY <br /> 2640 KELLY AVE <br /> EXCELSIOR, MN 55331 <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. 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 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 arc <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> iC".��� (o � 3 /O � l � <br /> Applicant Per�itee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />