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T_ PERMIT <br /> €ITY OF ORONO PERMIT TYPE: <br /> 270 Kelley Parkway- P.O. Box 66 MECHANICAL <br /> Crystal Bay, Minnesota 55323 Permit Number: {�,-,::t 31 <br /> (612)473-7357 Date Issued: 0:_:/2r:./9F, <br /> SITE ADDRESS: <br /> 405 OLD CRYSTAL BAY RD S <br /> JB <br /> P. I .N. : 04-117-23-24-0004 <br /> 04 <br /> DESCRIPTION: <br /> 1 FIREPLACE FLUE SIZE 5" FUEL NATURAL GAS <br /> MAKE HEAT N GLO MODEL GV5000 <br /> OUTPUT 7.:0,000 INPUT 70,000 <br /> i <br /> REMARKS: <br /> FEE SUMMARY: <br /> Base Fee $35 .00 <br /> surcharge 1-Ear <br /> Total Fee $035. 52 <br /> CONTRACTOR: ! — Applicant — OWNER: <br /> MISSION MECHANICAL 35301432 BECKMAN _nHN <br /> 11449 YATES' AVE N 405 OLD CRYSTAL BAY RD S <br /> C:HAMPL I N 1 MN 55316 FROND MN 55356 <br /> (F.12) 5:30-1432 <br /> [ '-, .1 , ' . 1' -4'''',1'12: ' ' ''':- ,-. ''';1,-;::-:'-'1"-.1 <br /> THE UND RS I G ED HERESY EQ ESTS PERM I SSI +1 TO MAKE THE AL S I {"°. VEMI <br /> SPECIFIED A AGREES Ti 00 ALL �K; IN,.STRI T SLI E WI �L CITY <br /> C RONO ORD�I N ICES AND ST TE OF ,,MINNESOTA BUILD/4e; C- T .. <br /> /' Y h r'j,'ri `U §c <br /> APPLICANT/PERMITEE SIGNATURE '- ISSUED BY:SIGNATURE <br />