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CITY OF ORONO PERMIT NO.: 2009-00006 <br /> , �, 2750 KELLEY PARKWAY <br /> ` ORONO, MN 55356- DATE ISSUED: OU06/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 4040 DAHL RD <br /> PIN : 07-1 17-23-1 1-0021 <br /> LEGAL DESC : P[RATES COVE <br /> : LOT 017 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WA"I�ER 1 fEA"I'ER <br /> APPLICANT WATER HEATER I5.00 <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 MISC FEE 0.00 <br /> TOTAL 17.00 <br /> OWNER <br /> LEPPLA, MR& MRS JOHN <br /> 4040 DAHL RD <br /> MOUND, MN 55364 <br /> AGREEMENT AND SWORN STATEMENT <br /> The��ork for��hich this permit is issued shail 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 rype 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 I 80 days at any time after work has commenced. <br /> "1'he applicant is responsible for assuring all required inspections are <br /> requested in conformance with[he State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> ��1�L�f. �L, / / � � <br /> Applicant Pcrmitee Signature Date Issued B �gnature _ _ Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRI D ABOVE. <br />