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CITY OF ORONO * 2 0 1 5 - 0 1 5 4 3 * <br /> 1 ^ 2750 KELLEY PARKWAY DATE ISSUED: 12/10/2015 <br /> t ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1485 GREEN TREES RD <br /> PIN : 11-117-23-23-0011 <br /> LEGAL DESC : GREEN TREES ON TANAGER LAKE <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> APPLICANT PLUMB[NG FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 1.00 <br /> LEGACY MECHAN[CAL SERVICES MAIL-IN FEE 2.00 <br /> 114 THOMAS CIRCLE#106 <br /> MONTICELLO, MN 55362- TOTAL 18.00 <br /> (763)314-0877 Payment(s) <br /> CHECK 007862 18.00 <br /> OWNER <br /> MARLIEM& MAI THOR,JOHANNES <br /> 1485 GREEN TREES RD <br /> WAYZATA, MN 55391- <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 separate <br /> permits. All provisions of laws and ordinances goveming 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 construction is <br /> suspended for a period of I 80 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 /> � r � � �� / �- r <br /> ���r��( � 1 I � __� P�,��X/h ����_�` � �l.; l�'j ( � / I � <br /> Applicant Permitee Signature Date Issued By S�gnature._ Date <br />