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� ` CITYOFORONO * 2017 - a0 � 77 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/07/2017 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2650 KELLY AVE <br /> PIN : 20-117-23-14-0005 <br /> LEGAL DESC : APPLE HILL <br /> : LOT 007 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,600.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> GAS LOG SET INSTALLATION-NATURAL GAS <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 0.80 <br /> TWIN CITY FIREPLACE STONE CO INC MAIL-IN FEE 2.00 <br /> 6521 CECILIA CIR <br /> EDINA,MN 55439- TOTAL 52.80 <br /> (952)777-4125 Payment(s) <br /> Minnesota State License#:mech-MB682977 CREDIT CARD 5715 52.80 <br /> OWNER <br /> STEINMEYER,CHELSEA&DEVON � <br /> 2650 KELLY AVE <br /> EXCELSIOR,MN 55331- <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 sepazate <br /> permits. All provisions of Iaws 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 l80 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 permit may be <br /> revoked at any time for due cause. <br /> � , <br /> ( Y�/(.lr�.L-�'.�G�� 2) ���(! L . ;�"ZJ �l � / �/ <br /> , <br /> Applicant Permitee Signature Date Issued By ature Date <br />