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� , CITY OF ORONO PERMIT NO.: 2010-00356 <br /> , 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: OS/17/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1375 REST POINT RD <br /> PIN : 07-117-23-32-0037 <br /> LEGAL DESC : SUBD REST POINT PARK LAKE MTKA <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 /> BAXTER MECHANICAL STATE SURCHARGE PLBG(<$500) 0.50 <br /> PO BOX 591 <br /> ELK RIVER, MN 55330- MAIL-IN FEE 2.00 <br /> (612)227-6710 MISC FEE 0.00 <br /> Minnesota State License#: 066036 PM TOTAL 17.50 <br /> OWNER <br /> GERLICHER,MR. &MRS. <br /> 1375 REST POINTT RD <br /> MOUND,MN 55364 <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 sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shail be compied with whether or not specified herein.This pertni[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 consWction 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 with tae State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> `�C� �-�- i i d-7i�.�-n, i i <br /> Applicant Permitee Signature Date Issued By Si ture <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED AB . <br />