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CITY OF ORONO PERMIT NO.: 2010-00826 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 09/13/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 975 TONKAWA RD <br /> PIN 08-117-23-21-0015 <br /> LEGAL DESC PARWOOD <br /> LOT 001 BLOCK 001 <br /> PERMIT TYPE PLUMBING(<$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE WATER HEATER <br /> NOTE: WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> 906 IST STREET S INC STATE SURCHARGE PLBG(<$500) 5.00 <br /> 906 ST <br /> WAITE PARK,MN 56387- MAIL-IN FEE 2.00 <br /> (320)251-2505 TOTAL 22.00 <br /> Minnesota State License#:65257 PAID WITH CC# 7541 <br /> OWNER <br /> LUNDQUIST,DAVID&MERILEE <br /> 180 YACHT CLUB#104 <br /> HYPOLYXO,FL 33462 <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 du cause. <br /> Applicant Permitee Signature Date jIssutB�ySignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />