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CITY OF ORONO * 2 0 1 4 - PJ 0 7 9 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/28/2014 <br /> ' ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1480 SIXTH AVE N <br /> PIN : 26-118-23-32-0008 <br /> LEGAL DESC : DOUGLAS ESTATES <br /> : LO'[' 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING (> $500) <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NO"I�E: 1S'1'PLOOR: I WC, 1 LAV, 1 KITCHEN SINK, 1 DISHWASHGR,I WA7'L;RHGATER <br /> VALUATION OF PLUMBING 5000 <br /> APPLICANT PLUMBING FIXTURE FEE 62.50 <br /> STATE SURCHARGE PLBG (VALUATION) 2.50 <br /> AMERICAN MECHANICAL CO, INC. TOTAL 65.00 <br /> 7120 71ST AVE.N. <br /> PO BOX 205 Payment(s) <br /> LORETTO, MN 55357- CREDIT CARD 6915 65.00 <br /> (612)750-0278 <br /> OWNER <br /> GULBRANDSON, DAN & ERICKA <br /> 1480 SIXTH AVE N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> I'he work for which this permit is issued shall be performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> State F3uilding Code. This pennit is for only the work describcd and does <br /> not grant perniission for additional or related work wllich requires separate <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 construction authorized is not <br /> commenced within 1 AO days of the date of issuance,or if construction is <br /> suspended for a p io of 80 days at any time after work has commenced. <br /> The applicant is tesp nsi �for assuring all required inspections are <br /> requested in confori an vith the State Building Code.'[�his pennit may bc <br /> revoked at any�timG'for ie cause. <br /> � �� � ��l <br /> , , <br /> Appl cant �rm t Signature Date Issued By Sig t re Date <br /> v� <br />