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� ' CITY OF ORONO * Z 0 1 7 - 0 PJ 6 9 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/28/2017 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2060 SIXTH AVE N <br /> PIN : 27-118-23-31-0002 <br /> LEGAL DESC : UNPLATTED 27 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: INSTALL NEW RPZ TO REPLACE 9D DEVICE ON BOILER MAKEUP WATER FEED <br /> VALUATION OF PLUMBING 1311 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.66 <br /> HARRIS COMPANIES MAIL-IN FEE 2.00 <br /> 909 MONTREAL CIRCLE <br /> ST PAUL, MN 55102- TOTAL 52.66 <br /> Minnesota State License#: plbg-PC642810 Payment(s) <br /> CHECK 589604 52.66 <br /> OWNER <br /> Trinity Lutheran Church <br /> 2060 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 type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void ifconstruction authorized is not <br /> commenced within l80 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 cause. <br /> � �a�.�� �7 <br /> Applicant Permitee Signature Date Issued By ' ature Date <br />