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CITY OF ORONO I I � I II I I I I I I I II� i � l � II <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/16/2018 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 765 BOULDER DR <br /> PIN : 33-118-23-11-0134 <br /> LEGAL DESC : STONEBAY <br /> : LOT 1&2 BLOCK 1 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,890.00 <br /> NOTE: ALL TESTING REPORTS SHALL BE ON SITE AT FINAL INSPECTION. <br /> UHT GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 0.95 <br /> 2700 FAIRVIEW AVE MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 52.95 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512060 CREDIT CARD 4616 52.95 <br /> OWNER <br /> Stonebrook Development LLC <br /> 17149 LINCOLN ST NE <br /> HAM LAKE,MN 55304- <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 /> (Wa/tZe- <br /> LYit-kb ke , (8/ <br /> Applicant Permitee Signature Date Issu B; Signature Date <br />