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CITY OF ORONO * Z 0 1 4 - 0 0 1 9 7 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 03/12/2014 <br /> � ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1655 FOX ST <br /> PIN : 02-117-23-33-0014 <br /> LEGAL DESC : HANSER ADDN <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS <br /> VALUATION : $ 1,500.00 <br /> NOTE: REPLACE EXIS"(�[NG GAS LOG SET <br /> HOOK TO�I'HE EXISTING GAS LINE <br /> R11P 6-46-30-1 1 <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 0.75 <br /> WOODLAND STOVES& FIREPLACES MAIL-IN FEE 2.00 <br /> 2901 E. FRANKLIN AVE. <br /> MINNEAPOLIS, MN 55403- TOTAL 52.75 <br /> (612)338-6606 Payment(s) <br /> CHECK 44444 52.75 <br /> OWNER <br /> MIGLIORI, RICHARD&JOAN <br /> 1655 FOX ST <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMEIVT <br /> I�he�cork for which this permit is issued shall be performed according to <br /> Uie approved plans and specifica[ions,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission tbr additional or related work�vhich 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[ime after work has commcnced. <br /> The applicant is responsible for assuring all required inspec[ions are <br /> requested in conformance with the State I3uilding Code.This permit may be <br /> revoked at any time tbr due ca�se. <br /> Y�'\ / / <br /> Applicant Permitee Signature Date Issued I3y naturc Date <br /> � <br />