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CITY OF ORONO * 2 0 1 3 — PJ 0 9 1 7 * <br /> � . � 2750 KELLEY PARKWAY nATE iss[1�n: 09/09/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2905 SIXTH AVE N <br /> PIN : 28-118-23-31-0006 <br /> LEGAL DESC : GARDEN GROVE <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: PLUMBING PIXTURES-(1)WATGR CLOSET,(2)LAVATORIES AND(l)BATHTUB <br /> VALUATION OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> BEN SCHERER PLUMBING & HVAC INC. STATE SURCHARGE PLBG (VALUATION) 1.25 <br /> 4520 85TH STREET SE <br /> DELANO, MN 55328- TOTAL 51.25 <br /> (763)972-8L.i7 PAID WITH CC# 4343 <br /> OWNER <br /> ELLINGSON,JORGEN & YUMIKO <br /> 2905 S[XTH AVE N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> l�he work for which this permit is issued shall be performed according to <br /> [he 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 hcrein."I�his permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of[he 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 Quilding Code.This permit may be <br /> revoked at ny time Y'or due cause. <br /> � � 1 /� �---�t �� �� <br /> Ap icant Permitee Signature Date Iss By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCWBED ABOVE. <br />