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CITY OF ORONO T I I I 11 11 11111 I1 <br /> * 20 1 7 - 0 1 6 79 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/29/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1920 FAGERNESS POINT RD <br /> PIN : 17-117-23-23-0031 <br /> LEGAL DESC : FAGERNESS <br /> : LOT 027 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 4,560.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> (2)HHT 6000CL-IPI-S 45,000 BTU <br /> APPLICANT MECHANICAL 57.00 <br /> STATE SURCHARGE MECH(VALUATION) 2.28 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 61.28 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 61.28 <br /> OWNER <br /> DAUM,GEORGE <br /> 1920 FAGERNESS PT 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 are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> mi <br /> Applicant Permitee Signature Date Issue:y Signature Date <br />