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• CITY OF ORONO <br /> 2750 KELLEY PARKWAY * 2 P1 1 3 - 0 0 Z 7 3 * <br /> DATE ISSUED: 04/23/2013 <br /> ' ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1480 LONG LAKE BLVD <br /> PIN : 26-118-23-33-0027 <br /> LEGAL DESC : REG. LAND SURVEY NO.0934 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 <br /> 12850 CHESTNUT BLVD <br /> SHAKOPEE,MN 55379 MAIL-IN FEE 2.00 <br /> (952)445-4803 TOTAL 22.00 <br /> Minnesota State License#: 057209PM <br /> OWNER <br /> BRADEN,ANITA&KEITH VANDER <br /> 1480 LONG LAKE BLVD <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. 'I'his 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 consVuction 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 /> ��1�L� GK- / i / / <br /> Applicant Permitee Signature Date Issued By S' ature ate <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . <br />