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2015-00818 -plumbing
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4205 Forest Lake Drive - 07-117-23-12-0027
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2015-00818 -plumbing
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Last modified
8/22/2023 5:30:45 PM
Creation date
8/12/2020 2:49:43 PM
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x Address Old
House Number
4205
Street Name
Forest Lake
Street Type
Drive
Address
4205 Forest Lake Dr
Document Type
Permits/Inspections
PIN
0711723120027
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�, CITY OF ORONO * 2 0 1 5 - 0 0 8 1 8 * <br /> " "1 2750 KELLEY PARKWAY DATE ISSUED: 06/24/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4205 FOREST LAKE DR <br /> PIN : 07-117-23-12-0027 <br /> LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN <br /> : LOT 005 BLOCK 003 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: REPLACE UISHWASHER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG (<$500) 5.00 <br /> APPLIANCE INSTALLERS OF MN INC. MAIL-IN FEE 2.00 <br /> 14105 RUTGERS ST.NE <br /> PRIOR LAKE, MN 55372- TOTAL 22.00 <br /> (952)469-8341 Payment(s) <br /> CHECK 1677 22.00 <br /> OWNER <br /> LEMIRE, JEROME <br /> 4205 FOREST LAKE DR <br /> MOUND, MN 55364 <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 due cause. <br /> � <br /> (vu.,a-r�c� e s� G � z�/`5 <br /> Applicant Permitee Signature Date [ss ed Signature Date <br />
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