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° CITY OF ORONO * 2 0 1 2 - 0 0 5 5 6 * <br /> �� 2750 KELLEY PARKWAY DATE ISSUED: 06/19/2012 <br /> , ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 3548 IVY PL <br /> PIN : 20-117-23-42-0017 <br /> LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO <br /> : LOT 174 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) 5.00 <br /> PO BOX 591 <br /> ELK RIVER,MN 55330- MAIL-IN FEE 2.00 <br /> (612)227-6710 TOTAL 22.00 <br /> Minnesota State License#: 066036 PM <br /> OWNER <br /> PYLE,MR.&MRS.CHARLES <br /> 3548 IVY PL <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 dces <br /> not grant permission for additional or related work which requires sepazate <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 consWction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction 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 the State Building Code.This permit may be � <br /> revoked at any time for due Cause. <br /> �'KQ'�'� �"�` � � � /�`''�`'n, / / <br /> Applicant Perrnitee Signature Date Issued By ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />