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' CITY OF ORONO <br /> * 2 0 1 4 - 0 0 4 3 4 * <br /> + 2750 KELLEY PARKWAY DATE ISSUED: OS/12/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 1453 PARK DR <br /> PIN : 07-117-23-42-0022 <br /> LEGAL DESC : SAGA HILL REVISED <br /> : LOT 009 BLOCK O15 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 3,200.00 <br /> NOTE: KOZY HEAT GAS FP <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.60 <br /> GLOWING HEARTH AND HOME MAIL-IN FEE 2.00 <br /> 100 ELDORADO DRIVE <br /> JORDAN, MN 55352 TOTAL 53.60 <br /> (952)495-2927 Payment(s) <br /> CHECK 18884 53.60 <br /> OWNER <br /> O'KEEFE,JUSTIN&NICOLE <br /> 1453 PARK DRIVE <br /> MOLJND, MN 55364- <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 /> { <br /> \_�r"�"�. l l <br /> Applicant Permitee Signature Date Issued By ature ��tD� Date <br /> O� <br />