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CITY OF ORONO * 2 0 1 5 - 0 0 1 7 1 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 02/10/2015 <br /> t ORONO, MN 55356- <br /> (952 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 645 NORTH ARM DR <br /> PIN : 06-117-23-43-0012 <br /> LEGAL DESC : REG. LAND SURVEY NO. 1508 <br /> : LOT 000 BLOCK 000 <br /> PERMTT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 5.00 <br /> CROIX CRYSTAL MAIL-[N FEE 2.00 <br /> 3440 YOERG DR TOTAL 22.00 <br /> HUDSON, WI 54016- <br /> (715)386-8667 Payment(s) <br /> CHECK 13389 22.00 <br /> OWNER <br /> SHIN,KWANG&BARBARA <br /> 645 NORTH ARM DR <br /> MOUND,MN 55364- <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 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 /> revoked at any time for due cause. <br /> �/ <br /> i �`7'Y�C.��I 2_ � I G'� ! . <br /> Applicant Permitee Signature Date Issued By Signature Date <br />