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CITY OF ORONO PERMIT NO.: 20o�-oos�s <br /> ~ 2750 KELLEY PARKWAY <br /> �' ORONO,MN 55356- DATE ISSUED: 08/24/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2178 SHADYWOOD RD <br /> PIN : 17-117-23-42-0009 <br /> LEGAL DESC : WILEYS PARK LAKE MTKA <br /> : LOT 017 BLOCK 001 <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- MAIL-IN FEE 1.50 <br /> (612)827-4033 TOTAL 17.00 <br /> OWNER <br /> ANDERSON,MR.&MRS. CURTIS <br /> 2178 SHADYWOOD RD <br /> WAYZATA,MN 55391 <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 /> permiu. 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 consVuction 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 aze <br /> requested in conformance wj�h the State Building Code.This permit may be <br /> revoked at any time�r due cause. <br /> %/��'".� �1t' l l �G�-�,���►+'(, l l <br /> Applicant Permitee Signature Date Issued B gnature Hat�-- <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />