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� CITY OF ORONO * z 0 1 4 - 0 0 1 7 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/03/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3185 SIXTH AVE N <br /> PIN : 28-118-23-32-0006 <br /> LEGAL DESC : UNPLATTED 28 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NO"1'1�: PLUMB[NG PIXTURES: <br /> (3)WATER CLOSETS,(�F)LAVATOR►ES,(1)I3ATHTUB AND(1)SHOWER <br /> VALUATION OF PLUMBING 8500 <br /> APPLICANT PLUMBING FIXTURE FEE 106.25 <br /> STATE SURCHARGE PLBG(VALUATION) 4.25 <br /> RICK'S PLUMBING SERVICES LLC TOTAL 110.50 <br /> 14015 SPRING LAKE ROAD <br /> MINNEAPOLIS, MN 55402- Payment(s) <br /> (952)933-3132 CREDIT CARD 2641 110.50 <br /> Minnesota State License#: PLUM-PC648723 <br /> OWNER <br /> BRANTINGHAM, HENRY&NANCY <br /> 3185 SIXTH AVE N <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work for which this permit is issued shall be performed according to <br /> the approved plans and speciYications,applicable City approvals,and the <br /> State Building Code. "This permi[is for only the work described and does <br /> not grant permission for additional or related work which rcquires 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 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 afrer work has commenced. <br /> "I he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked an time for due cause. <br /> � n I ` - <br /> i _-� <br /> J � �_ �° � _<, r -- <br /> � � _. ` �v,� ,� � <br /> Applicant Permitee Signature ate �� Iss � By Signature Date <br /> ` <br />