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r � <br /> CITY OF ORONO * Z 0 1 4 - 0 0 5 6 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/09/2014 <br /> ORONO, MN 55356- <br /> 952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1135 LOMA LINDA AVE <br /> PIN : 08-117-23-23-0019 <br /> LEGAL DESC : LOMA LINDA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 2,000.00 <br /> NOTE: KOZY HEAT GAS FACTORY FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> PRACTICAL SYSTEMS STATE SURCHARGE MECH(VALUATION) 1.00 <br /> 4342B SHADY OAK RD MAIL-IN FEE 2.00 <br /> HOPKINS,MN 55343 TOTAL 53.00 <br /> (952)933-1868 Payment(s) <br /> CREDIT CARD 0961 53.00 <br /> OWNER <br /> THURLO,MR.&MRS.MARK <br /> 1135 LOMA LINDA AVE <br /> MOUND,MN 55364 <br /> AGREEMENT AND SWORN STATEMEIVT <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 does <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 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 the State Building Code.This pe it may be <br /> revoked at any time for due cause. <br /> i (o � / <br /> Applicant Permitee Signat re Date Issue y Signature Date <br />