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� CITYOFORONO * 2014 - 0PJ832 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: 08/04�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 /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: BASEMENT: i WC, 1 LAV, 1 TUB <br /> VALUATION OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.25 <br /> BOE PLUMBING TOTAL 51.25 <br /> 15481 KIOWA ST. <br /> ANDOVER,MN 55304 Payment(s) <br /> (763)757-1991 CHECK 4162 51.25 <br /> Minnesota State License#:plbg-MB3984 <br /> OWNER <br /> GULBRANDSON,DAN&ERICKA <br /> 1480 SIXTH AVE N <br /> LONG LAKE,MN 55356- <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 governing this rype 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 aRer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in wnformance with the State Building Code.This permit may be <br /> revoked at time for d cause. <br /> �r�l f , , <br /> Applic t ermitee Signature Date lssued By g ature Date <br />