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CITY OF ORONO PERMIT NO.: 2008-00160 <br /> 2750 KELLEY PARKWAY <br /> 4, ORONO, MN 55356- DATE ISSUED: 08/21/2008 <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1995 WEST FARM RD <br /> PIN : 27-118-23-43-0013 <br /> LEGAL DESC : THE FARM AT LONG LAKE <br /> : LOT 011 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: <br /> WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 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 /> Minnesota State License#: 061521-PM <br /> OWNER <br /> PARRISH,RICHARD <br /> 1995 WEST FARM RD <br /> LONG LAKE,MN 55356 <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 /> ~ t l i j I' ffl aiog <br /> Applicant Permitee Signature Date <br /> Issued By ature � Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBEtABOVE. <br />