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� " CITY OF ORONO * Z 0 1 6 - 0 PJ PJ 7 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU20/2016 <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 <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: REPLACE 2 KITCHEN SINKS <br /> VALUATION OF PLUMBING 900 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.45 <br /> SAM HENDRICKSON PLBG&HEATING INC TOTAL 50.45 <br /> 29901 725TH AVE Payment(s) <br /> DASSEL,MN 55325- CREDIT CARD 7507 50.45 <br /> Minnesota State License#:plbg-PC646230,mech-MB005006 <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 separa[e <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 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 <br /> revoked at any time for due c se. -� � <br /> , <br /> � ��j � <br /> �� � <br /> � — - <br /> ' ���\,��� � .�.�. ��`l I / ,-' (-'/ ( (1, <br /> Applicant Permit ignature Date Issued By Sigtsature Date <br />