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CITY OF ORONO PERMIT NO.: 2011-00135 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- �ATE ►ssu�u: 02/28/2011 <br /> ' 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2860 DEER RUN TR <br /> PIN : 04-1 17-23-24-0014 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 009 BLOCK 004 <br /> NERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> 4 <br /> � <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> NORBLOM PLUMBING CO. STATE SURCHARGE PLBG (<$500) 5.00 <br /> 2905 GARFIELD AVENUE S. <br /> MINNEAPOLIS, MN 55408- MAIL-fN FEE 2.00 <br /> ( (612) 827-4033 MISC FEE 0.00 <br /> TOTAL 22.00 <br /> OWNER <br /> CUMMING, JOHN K <br /> 2860 DEER RUN TRAIL <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc ti�ork for�vhich this permit is issued shall be performcd according to <br /> the approvcd plans and specitications,applicable City�approvals,and thc <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission Far additional or rclaled work which requires separate <br /> permits. All pro��isions ofla��s and ordinances govcrning this typc of�vork <br /> shall bc compicd witli�vhed�cr or not specified herein.This pennit will � <br /> expire and becomc null and void if construction authorized is not <br /> commenced within 180 days uf the date of issuancc.or if construction is ��� <br /> suspended for a period ot�180 days at any time after�vork has commenced. <br /> Thc applicant is responsible for assuring all required inspections are <br /> requested in conformance���ith the State l3uilding Code.This permit may be <br /> revoked at any lime for due oause. <br /> �,�'�l�fiCit� (�,C� � � i�lYC.3��CJ <br /> / <br /> Applicant Permitee Signature Date Issued By,�gnature <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO <br />