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CITY OF ORONO * 2 0 1 7 - 0 0 a 2 2 * <br /> + 2750 KELLEY PARKWAY DATE ISSUED: OU1U2017 <br /> ; ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1122 LOMA LINDA AVE <br /> PIN : 08-117-23-23-0026 <br /> LEGAL DESC : LOMA LINDA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 5,225.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> REPLACE:GAS FACTORY FIREPLACE(HHT) <br /> APPLICANT MECHANICAL 6531 <br /> STATE SURCHARGE MECH(VALUATION) 2.61 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 69.92 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 69.92 <br /> OWNER <br /> BERGH,HANS&SHARON <br /> 905 WILLOW VIEW DR <br /> LONG LAKE,MN 55356- <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 Ciry 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 separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified hereia 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 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. �_._ f� <br /> '/� �� :� <br /> ����:c 1 u� ���;� � P--�—����J �, � �, r <br /> Applicant Permitee Signature Date Issued By Signature Date <br />