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• 111' <br /> CITY OF ORONO Ii III11111 _' <br /> * 20 1 2 - 00726 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/30/2012 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 1130 OLD CRYSTAL BAY RD S <br /> PIN : 09-117-23-14-0007 <br /> LEGAL DESC : COLWELL ADDN <br /> : LOT 000 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 1700 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> BENJAMIN FRANKLIN PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.85 <br /> 1424 3RD STREET N <br /> MINNEAPOLIS,MN 55411- MAIL-IN FEE 2.00 <br /> (763)755-6468 MISC FEE 0.00 <br /> TOTAL 52.85 <br /> OWNER <br /> Colwell Industries,Inc. <br /> COLWELL,THOMAS&PHYLLIS <br /> 123 3RD STREET N <br /> MINNEAPOLIS,MN 55401- <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 /> Applicant Permitee Signature Date Issued y Sityature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO f'. <br />