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� - CITY OF ORONO PERMIT NO.: 2009-00116 <br /> 2750 KELLEY PARKWAY ' <br /> • ORONO, MN 55356- DATE ISSUED: 03/19/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4465 NORTH SHORE DR <br /> PIN : 07-117-23-31-0003 <br /> LEGAL DESC : BERGQUISTS ADDN TO SAGA HILL <br /> : LOT 005 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT WATER HEATER 15.00 <br /> NORBLOM PLUMBING CO. STATE SURCHARGE PLBG(<$500) 0.50 <br /> 2905 GARFIELD AVENUE S. <br /> MINNEAPOLIS,MN 55408- MISC FEE 1.50 <br /> (612)827-4033 TOTAL 17.00 <br /> OWNER <br /> THEISEN,BARBARA&JOHN <br /> 4465 NORTH SHORE 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. T'his permit is for only the work desctibed and does <br /> not grant perrrtission for additional or related work which requires sepazate , <br /> permits. All provisions of laws and ordinances goveming 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 witF►in 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due caLse. <br /> `�'YjC#,l,L �, l l G�;''�'t.D��'`� l l <br /> Applicant Permitee Signature Date Issued B ignature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />