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� CITY OF ORONO PERM�T No.: 2oii-0003s <br /> � 2750 KELLEY PARKWAY <br /> , ORONO, MN 55356- �ATE �ssuE�: OU18/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : l 17 CHEVY CHASE DR <br /> PIN : 36-118-23-41-0014 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 009 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIY TYPE : WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> NORBLOM PLUMBING CO. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 2905 GARFIELD AVENUE S. <br /> MINNEAPOLIS, MN 55408- MAIL-IN FEE 2.00 <br /> (612) 827-4033 MISC FEE 0.00 <br /> TOTAL 22.00 <br /> OWNER <br /> ARTHUR, ALAN& CAROL <br /> 1 17 CHEVY CHASE DR <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which Uiis permit is issued shall be perfonned according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State I3uilding Code. This permit is for only the wark described and does <br /> not grant permission for additional or rclatcd wark which requires separate <br /> pennits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with�vhether or not specitied 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 issu�nce,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> Che applicant is responsible f�or assuring all required inspections are <br /> requested in conlonnance with thc State Building Code.This permit may be <br /> revoked at an��time for due cause. <br /> ,,1��� <br /> �__ i i i i <br /> ilpplicant Permitce Signature Date Issued L3y ig ature tc <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE AN DESCRIBED AB <br />