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CITY OF ORONO * 2 0 1 4 - 0 1 3 8 0 * <br /> 27_50 KELLEY PARKWAY DATE ISSUED: 11/26/2014 <br /> ORONO, MN 55356- <br /> � (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2732 CAROLINE AVF, <br /> PIN : 20-117-23-24-0041 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1451 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 1500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG (VALUATION) 0.75 <br /> LEGACY MECH SERVICES MAIL-IN FEE 2.00 <br /> 1 14 THOMAS CIRCLE#106 <br /> MONTICELLO, MN 55362- TOTAL 52.75 <br /> (763)314-0877 Payment(s) <br /> CHECK 7647 52.75 <br /> OW1vEK <br /> PERCIVAL, CHARLES& SUSAN <br /> 2732 CAROLINE AVE <br /> WAYZATA, MN 55�91- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be perlormed 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 fbr additional or rela[ed work which requires separate <br /> permi[s. All provisions ot�laws and ordinances goveming this type of work <br /> shall be compied�vith 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 ot�issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applican[is responsiblc for assuring all required inspections are <br /> reques[ed in conY'ormance with the State Building Code.'I'his permit may be <br /> revoked at any time Yor due cause. �� <br /> �'�/l/��`� / / � /,/ � <br /> Applicant Permitee Signature Date Issue By Signature DaCe <br />