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CITY OF ORONO * 2 0 1 S - 0 0 S 7 S <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/11/2015 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: 952 249-4616 <br /> ADDRESS 820 NORTH SHORE DR W <br /> PIN 07-117-23-22-0004 <br /> LEGAL DESC UNPLATTED 07 117 23 <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE PLUMBING(<$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE WATER HEATER <br /> NOTE: 1 WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECTIONS,INC. <br /> STATE SURCHARGE PLBG(<$500) 5.00 <br /> MAIL-IN FEE 2.00 <br /> 12850 CHESTNUT BLVD TOTAL 22.00 <br /> SHAKOPEE,MN 55379- <br /> (952)445-4803 Payment(s) <br /> Minnesota State License#:mech-MB004165 CHECK 6768 22.00 <br /> OWNER <br /> SEHR,REX REWERTS&MARY <br /> 820 NORTH SHORE DR W <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. G <br /> la_(L �,t,1'- <br /> Applicant Permitee Signature Date Issued By Signature Date <br />