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CITY OF ORONO * Z 0 1 4 - 0 0 9 4 8 * <br /> � <br /> 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2014 <br /> ORONO,MN 55356- <br /> ` (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3265 SIXTH AVE N <br /> PIN : 29-118-23-44-0002 <br /> LEGAL DESC : LJNPLATTED 29 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> STATE SURCHARGE PLBG(<$500) 5.00 <br /> APPLIANCE CONNECTIONS MAIL-IN FEE 2.00 <br /> 12850 CHEST'NUT BLVD TOTAL 22.00 <br /> SHAKOPEE, MN 55379 <br /> (952)445-4803 Payment(s) <br /> Minnesota State License#: cont-057209PM CHECK 5508 22.00 <br /> OWNER <br /> WICHMAN,MICHAEL&AVA <br /> 3265 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 sepazate <br /> permits. All provisions of laws and ordinances goveming this rype of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and bewme 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 cause. <br /> c <br /> l�l�,� l l <br /> Applicant Permitee Signature Date Issued By ature Date <br />