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CITY OF ORONO * 2 0 1 4 - 0 1 3 5 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1U19/2014 <br /> ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1250 LYMAN AVE <br /> PiN : 35-118-23-34-0015 <br /> LEGAL DESC : LYMAN WOODS <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 6,000.00 <br /> NOTE: AIR EXCHANGER <br /> APPLICANT MECHANICAL 75.00 <br /> STATE SURCHARGE MECH (VALUATION) 3.00 <br /> KLEVE&JC MECHANtCAL LLC MAIL-IN FEE 2.00 <br /> 12907 PIONEER TR TOTAL 80.00 <br /> EDEN PRAIRIE,MN 55347- <br /> Payment(s) <br /> CREDIT CARD 7744 80.00 <br /> OWNER <br /> DWORSKY, WILLIAM& BETH <br /> 1250 LYMAN 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 Ciry approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for aAdiCioh�1 or reiated 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 specitied 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 /> t <br /> G(� �� __ ��E_ C�7'yl c.c.h �l � l� ( <br /> Applicant Permitee Signature Date Issued By Signature Date <br />