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1 I ! II II II <br /> CITY OF ORONO * 2'0 i 7��_ 0� I ���� <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/28/2017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 500 OLD CRYSTAL BAY RD S <br /> PIN : 04-1171-23-42-0029 <br /> LEGAL DESC : CRYSTAL BAY RETREAT <br /> : LOT I BLOCK 1 <br /> PERMIT TYPE : MECHANICAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,70'7.00 <br /> NOTE: ALL TESTING REPORTS SHALL 3E ON SITE AT FINAL INSPECTION. <br /> HHT GAS FACTORY FIREPLACE-MOD L SL-7 <br /> APPLICANT MECHANICAL 50.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 0.85 <br /> 2700 FAIRVIEW AVE MAIL-IN FEE 2.00 <br /> ROSEVILLE,MN 55113 TOTAL 52.85 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mech-20512(60 CREDIT CARD 4616 52.85 <br /> OWNER <br /> MERZ,BRIAN&KATIE <br /> 2412 BLACK LAKE RD <br /> SPRING PARK,MN 55384- <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 hergin.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuanc ,or if construction is <br /> suspended for a period of 180 days at any time a$Cr work has commenced. <br /> The applicant is responsible for assuring all requir d 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 y ature Date <br />