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CITY OF ORONO PERMIT NO.: 2004-07731 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 07/2112004 <br /> (952)249-4600 FAX: (952)249-4616 <br /> REPRINTED ON 10/14/2010 <br /> ADDRESS 270 NORTH SHORE DR W <br /> PIN 06-117-23-23-0019 <br /> LEGAL DESC IDYLLVALE FARM <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE MECHANICAL PRE 7/1/2008 <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIREPLACE-GAS <br /> APPLICANT PERMIT FEE SCHEDULE 35.00 <br /> AUTOMATIC GARAGE DOOR&FIREPLACE STATE SURCHARGE(VALUATION) 0.50 <br /> 8900-109TH AVE N- <br /> CHAMPLIN,MN 55316 TOTAL 35.50 <br /> OWNER <br /> TASTAD,JOHN M&KIMBERLEY <br /> 210 NORTH SHORE DR W <br /> MOUND,MN 55364- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according too <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 /> Applicant Permitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />