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� , � � <br /> CITY OF ORONO * 2 0 1 3 - 0 0 B 6 3 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 08/26/2013 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2140 SIXTH AVE N <br /> PIN : 27-118-23-31-0026 <br /> LEGAL DESC : PHILLIPS WOODLAND TERRACE 3RD ADDN <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER HEATER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 <br /> 12850 CHESTNUT BLVD <br /> SHAKOPEE,MN 55379 MAIL-IN FEE 2.00 <br /> (952)445-4803 TOTAL 22.00 <br /> Minnesota State License#: 057209PM PAID WITH CC# 5244 <br /> OWNER <br /> PHILLIPS, PAUL&MARY <br /> PO BOX 755 <br /> LONG LAKE, MN 55356-0755 <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 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 I SO 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 use. <br /> �' �e210� � 8'�02.�0� �,3 <br /> App�cant ermi ture Date Issu By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />