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CITY OF ORONO PERMIT NO.: 2010-01136 <br /> 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- DATE ISSUED: 1 U18/2010 <br /> � 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 60 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0020 <br /> LEGAL DESC : REG. LAND SURVEY NO.0446 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,900.00 <br /> NOTE: 1 HEAT N GLO FACTORY GAS FP <br /> APPLICANT MECHANICAL 50.00 <br /> AMERICAN AIR SUPPLY, INC. STATE SURCHARGE MECH(VALUATION) 5.00 <br /> 11257 207TH AVE NW <br /> ELK RIVER,MN 55330 MAIL-IN FEE 2.00 <br /> (612)282-7568 MISC FEE 0.00 <br /> TOTAL 57.00 <br /> OWNER <br /> HARTMAN,TODD <br /> 60 MYRTLEWOOD RD <br /> WAYZATA,MN 55391- <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 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ' " _ _ ' c,.�.`— / / / / <br /> Applicant Permitee Signature Date Issued By nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />