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2010-00251 - water heater
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4250 Forest Lake Drive - 07-117-23-12-0022
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2010-00251 - water heater
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Last modified
8/22/2023 5:30:40 PM
Creation date
8/12/2020 2:50:05 PM
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x Address Old
House Number
4250
Street Name
Forest Lake
Street Type
Drive
Address
4250 Forest Lake Dr
Document Type
Permits/Inspections
PIN
0711723120022
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. � <br /> CITY OF ORONO PERMIT NO.: 2010-00251 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE IssuEn: 04/22/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4250 FOREST LAKE DR <br /> PIN : 07-117-23-12-0022 <br /> LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN <br /> : LOT 000 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WA"C}3R FIEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> NORBLOM PLUMBING CO. STATE SURCHARGE PLBG (<$500) 0.50 <br /> 2905 GARFIELD AVENUE S. <br /> MINNEAPOLIS, MN 55408- MAIL-IN FEE 2.00 <br /> (612)827-4033 TOTAL 17.50 <br /> OWNER <br /> ETAL, ROBERT DONGOSKE <br /> 4250 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 oniy the work described and does <br /> not grant pemiission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this typc of work <br /> shall be compied with whether or not specified hercin.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 tor a period of 180 days at any time after work has commenced. <br /> The applicant is responsibie for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked any time for due cau . <br /> `-� ' �,(. " �� - - � C1 � <br /> Applicant Per itee Signa ��e Date L� �'� l�o� L7 <br /> �� Is By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK HER THAN DESCRIBED ABOVE. <br />
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