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, <br /> CITY OF ORONO PERMIT NO.: 2010-00191 <br /> ' 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: 04/06/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1465 LONG LAKE BLVD <br /> PIN : 35-118-23-22-0005 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1379 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <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 MISC FEE 0.00 <br /> TOTAL 17.50 <br /> OWNER <br /> VANDERBRANDEN, ERIC <br /> 1465 LONG LAKE BLVD <br /> LONG LAKE, MN 55356- <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 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 authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of I80 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 /> revoked at any time for due cauye. <br /> 7�rt��.l � i i <br /> � � <br /> Applicant Permitee Signature Uate Issued By i nature Date <br /> SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />