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PERMIT <br /> icay OF ORONO PERMIT TYPE: <br /> 2750 Kelley Parkway- PO. Box 66 !4‘-! <br /> Permit Number: vt.);.7. 1 <br /> Crystal Bay, Minnesota 55323 <br /> Date Issued: / / <br /> (612) 473-7357 <br /> SITE ADDRESS: <br /> 189 WEST FARM RD <br /> P 1 N <br /> DESCRIPTION: <br /> S FIXTURES <br /> Plumbing Permit Type FIXTURES <br /> Plumbing Work Type RENOVATE/REMODEL <br /> 1 WATER CLOSET 1 LAVATORY 1 BATHTUB <br /> 1 SHOWER 1 WET E:AR <br /> REMARKS: <br /> FEE SUMMARY: <br /> VALUATION $3, 000 <br /> Base Fee $37 50 <br /> Surcharge <br /> Total Fee $39 . 00 <br /> CONTRACTOR: - Applicant - 0 OWNER: <br /> m IKE LARSON Pi t..4{; 2 9 2 0"7 i4H TEN. F' <br /> 3402 LIBRARY LA las3 WEST FWN RD <br /> ST LOUTS PARK b 4 7 E, RuNij MN <br /> (612) 936-0103 <br /> THE UNDERSICiNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVFMFNTS <br /> SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF <br /> ORONO ORDINANCES AND STATF OF MINNESOTA BUD COOF REQUIRFMENTS . <br /> L_ <br /> ( 5t\A4 .4/1/1L4;14/k,_ <br /> APPLICANT/PERMITE SIGNATURE I ISSUED BY:SIGNATURE r- <br />