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� x CITY OF ORONO PERMIT NO.: 2oiaooso3 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 06/2U2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 645 NORTH ARM DR <br /> PIN : 06-117-23-43-0012 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1508 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> NORBLOM PLUMBING CO. STATE SURCHARGE PLBG(<$500) 0.50 <br /> 2905 GARFIELD AVENUE S. <br /> MINNEAPOLIS,MN 55408- MAIL-IN FEE 2.00 <br /> (612)827-4033 TOTAL 17.50 <br /> OWNER <br /> SHIN,KWANG&BARBARA <br /> 645 NORTH ARM DR <br /> MOLTND,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 dces <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 /> 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 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 /> C`-✓vl a,c.���J b i a-� i �o q,v�. o��i /O <br /> Applicant Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />