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CITY OF ORONO PERMIT NO.: 2010-0�009 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO,MN 55356- DATE ISSUEn: 10/15/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3060 SIXTH AVE N <br /> PIN : 28-118-23-32-0014 <br /> LEGAL DESC : LESLIE ADDN <br /> : LOT 001 BLOCK 001 <br /> ; PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: PAID WITH CHECK 8611 FOR$32.00. PERMIT FEE IS$22.00. SENT THEM$]0.00 CASH BACK. BGS. OK PER PZ <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> WELD& SONS PLUMBING CO INC. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 3410 KILMER LANE N <br /> PLYMOUTH,MN 55441- MAIL-IN FEE 2.00 <br /> (763)475-0296 MISC FEE 0.00 <br /> TOTAL 22.00 <br /> PAID WITH CASH -10.00 <br /> OWNER <br /> KOSEK,CHRISTOPHER&HEATHER <br /> 3060 SIXTH AVE N <br /> LONG LAKE,MN 55356 <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 sepazate <br /> permits. All provisions of laws and ordinances goveming 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for d�ue ca�e. <br /> �j'1�c l/Yl. / / <br /> / / <br /> Applicant Permitee Signature Date Issued By nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED A VE. <br />