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CITY OF ORONOi 'Il 11 1'', <br /> * 20 1 S - 00303 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/16/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 105 OR O ORCHARD RD N <br /> PIN : 35-118- 3-33-0003 <br /> LEGAL DESC : UNPLA/FTED 35 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECH,p►NICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,5715.00 <br /> • NOTE: GAS FACTORY FIREPLACE <br /> BRAND-HHT <br /> MODEL#SLR-C I <br /> I <br /> i <br /> 1 <br /> I <br /> APPLICA T MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.79 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE,MN 55113 TOTAL 53.79 <br /> (651)633-2561 Payment(s) <br /> Minnesota State License#:mec -20512060 CREDIT CARD 4608 53.79 <br /> OW ER <br /> LOWE,JAMES&KELLY <br /> 105 ORONO ORCHARD RD <br /> LONG LAKE,MN 55356- <br /> AGREEMENT ANDSWORN STATEMENT <br /> The work for which this permit is ssued shall be performed according to <br /> the approved plans and specificati ns,applicable City approvals,and the <br /> State Building Code. This permi is for only the work described and does <br /> not grant permission for addition:I or related work which requires separate <br /> permits. All provisions of laws : d ordinances governing this type of work <br /> shall be compied with whether o not specified herein.This permit will <br /> expire and become null and vol. if construction authorized is not <br /> commenced within 180 days of he date of issuance,or if construction is <br /> suspended for a period of 180.:ys at any time after work has commenced. <br /> The applicant is responsible fo assuring all required inspections are <br /> requested in conformance wi the State Building Code.This permit may be <br /> revoked at any time for due c: se. <br /> ' -s6 4- / /14 / /5 <br /> Applicant Permitee Sign. re Date slued Signature Date <br /> 1 <br /> i <br /> i <br />