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CITY OF ORONO PERMIT NO.: 2oos-oo3�2 <br /> 2750 KELLEY PARKWAY <br /> r <br /> '` ORONO, MN 55356- DATE ISSUED: 10/20/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1030 LOMA LINDA AVE <br /> PIN : 07-117-23-14-0056 <br /> LEGAL DESC : LJNPLATTED 07 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,690.00 <br /> NOTE: <br /> 31 HEAT N GLO GAS FACTORY FP <br /> APPLICANT MECHANICAL 35.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 135 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 MAIL-IN FEE 1.50 <br /> (651)633-2561 TOTAL 37.85 <br /> Minnesota State License#:20512060 PAID WITH CASH OA1 <br /> OWNER <br /> WOLLNER,LORI HUINKER&GARY <br /> 1030 LOMA LINDA AVE <br /> MOUND,MN 55364 <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 separate <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 wnstruction 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 aze <br /> requested in conformance with the State Buiiding Code.This permit may be <br /> revoked at any time for due cause. <br /> `�t-a,�.2 !�. / / ioi �o � pg <br /> Applicant Permitee Signature Date Issued Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESC ED ABOVE. <br />