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CITY OF ORONO PERMIT NO.: 2009-00010 <br /> � 2750 KELLEY PARKWAY <br /> N ORONO, MN 55356- �ATE IssuEn: OU13/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 146 CHEVY CI-IASE DR <br /> PIN : 36-118-23-41-0045 <br /> LEGAL DESC : HILL O'WAY MANOR <br /> : LOT O11 BLOCK 002 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NO"CE: WATER IiEATER <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 /> OWNER <br /> ANDERSON, RETA& STEPHEN <br /> 146 CHEVY CHASE DR <br /> WAYZATA, MN 55391 <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc 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 Yor additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compicd 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 l80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in confonnance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ` u�(,/ / / <br /> / / <br /> Applicant Permitee Signature Datc Issued By i nature Date <br /> SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIB ABOVE. <br />