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, -� CITY OF ORONO * Z 0 1 4 - 0 1 3 4 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1 U17/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2660 LYDIARD AVE <br /> PIN : 21-117-23-23-0031 <br /> LEGAL DESC : VERN-MAR MANOR <br /> : LOT 005 BLOCK 000 <br /> P�RMIT TYPE : MECHANICAL(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIREPLACE-GAS I � , / <br /> VALUATION : $ 1,800.00 � �C�� � � V � V � <br /> NOTE: KO"Z_Y HGA"C JACKSON �IR�PLACE �(�' � � , � <br /> �✓�l 1�� �� I�'�'4 � <br /> � <br /> �� � � �° <br /> 3�� 3 /l� J, <br /> � <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH (VALUATION) 0.90 <br /> RIVER CITY SHEET METAL INC. MAIL-IN FEE 2.00 <br /> 8290 MAIN ST. NE TOTAL 52.90 <br /> SUITE 39 <br /> FRIDLEY, MN 55432 Payment(s) <br /> (612)754-2199 CHECK 10975 52.90 <br /> Minnesota State License#: mech-003364 <br /> OWNER <br /> BAUER, MR. & MRS. <br /> 2660 LYDIARD AVE <br /> EXCELSIOR, MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall bc performed according to <br /> the approved plans and specitications,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 /> pennits. All provisions of la�vs and ordinances governing this type of work <br /> shall be compied with whether or not specitied herein.This permit will <br /> expire and become null and void if eonstruction authorized is not <br /> commenced within 180 days ot�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 tbr due cause. <br /> � ' /l / �`� � � <br /> Applican ermi ee Signature D• e [ssue �y Signature Date <br />