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CITY OF ORONO * z 0 1 2 - 0 0 3 9 8 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/10/2012 <br /> ORONO, MN 55356- <br /> ` 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 124 CHEVY CHASE DR <br /> PIN : 36-118-23-41-0039 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT 005 BLOCK 002 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIY TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 1500 <br /> APPLICANT <br /> PLUMBING FIXTURE FEE 50.00 <br /> LEGACY MECH SERVICES STATE SURCHARGE PLBG(VALUAT[ON) 0.75 <br /> 9714 WOODCREST CT <br /> MONT[CELLO, MN 55362- MAIL-IN FEE 6.25 <br /> (763)219-8978 TOTAL 57.00 <br /> OWNER <br /> HIGGINS, FORREST&JENNIFER <br /> 124 CHEVY CHASE DR <br /> WAYZATA, MN 55391- <br /> AGREEMEIVT AND SWORN STATEMENT <br /> The work for which this permit�s 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 au[horized 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 al(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 /> Applicant Permitee Signature Date Issued By Sig a re 'Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE BOVE. <br />