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� <br /> CITY OF ORONO * 2 0 1 6 - 0 0 4 1 4 * <br /> �� � ' 2750 KELLEY PARKWAY DATE ISSUED: 04/25/2016 <br /> _ ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2693 SHADYWOOD RD <br /> PIN : 21-117-23-24-0055 <br /> LEGAL DESC : CHAPMAN ADDN <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : UNDEFINED <br /> NOTE: NEW DRIAN TILE&SUMP PUMP IN BASEMENT <br /> VALUATION OF PLUMBING 4097 <br /> APPLICANT PLUMBING FIXTURE FEE 51.21 <br /> STATE SURCHARGE PLBG(VALUATION) 2.05 <br /> COMPLETE BASEMENT SYSTEMS MpIL-IN FEE 2.00 <br /> 54004 LOREN DRIVE <br /> MANKATO,MN 56001- TOTAL 55.26 <br /> (507)387-0500 Payment(s) <br /> Minnesota State License#:BUIL-143377 CREDIT CARD 5821 53.26 <br /> CREDIT CARD 5821 2.00 <br /> OWNER <br /> WARNER,JAMES&WENDY <br /> 2693 SHADYWOOD RD <br /> EXCELSIOR,MN 55331- <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 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 180 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 n� <br /> revoked at any time for due cause. II� <br /> �--..� <br /> � /� <br /> J �l.`�..� I ��,L�..� I�L��- � i"�_.�.�v �1 / �'� � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />