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CITY OF ORONO PERMIT NO.: 2009-00�42 <br /> , � 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 10/2U2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2749 KELLY AVE <br /> PIN : 21-117-23-23-0027 <br /> LEGAL DESC : REG.LAND SURVEY NO.0891 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: INSTALLING GAS WATER HEATER-AIRTEST REQUIRED <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> TEARLE,CHAD&ELEANOR STATE SURCHARGE PLBG(<$500) 0.50 <br /> 2749 KELLY AVE <br /> EXCELSIOR,MN 55331- TOTAL 15.50 <br /> PAID WITH CC# 7304 <br /> OWNER <br /> TEARLE,CHAD&ELEANOR <br /> 2749 KELLY AVE <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shali 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 sepazate <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 /> revoke at any time for due caus . <br /> _ .�'���J�/�cl, �Di 2( i (l�( ���t� /oi a/i v <br /> Applicant Permitee Signature Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />