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CITY OF ORONO I It t II II!IH I i I , ITI I I20 1 3 - 002E17 *' <br /> 2750 KELLEY PARKWAY * DATE ISSUED: 04/25/2013 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 665 ORCHARD PARK RD <br /> PIN : 31-118-23-11-0005 <br /> LEGAL DESC : UNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 5,200.00 <br /> NOTE: HEAT N GLO GAS FIREPLACE TRUE-36C <br /> APPLICANT MECHANICAL 65.00 <br /> FIRESIDE HEARTH&HOME STATE SURCHARGE MECH(VALUATION) 2.60 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 <br /> (651)633-2561 TOTAL 69.60 <br /> Minnesota State License#:20512060 <br /> OWNER <br /> REYNOLDS,WILLIAM&MOLLIE <br /> 3630 LIVINGSTON AVE <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 <br /> for due cause.* <br /> 116.40a <br /> Applicant Permitee Signature Date Issued By gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED BOVE. <br />