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CITY OF ORONO � j 11* 01S - 00101 * <br /> I <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/23/2015 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2610 WEST LAFAYETTE RD <br /> PIN : 21-117-23-24-0043 <br /> LEGAL DESC : SHORE HILLS <br /> : LOT 011 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(1)LAVATORY AND(1)SHOWER <br /> VALUATION OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.25 <br /> SANTEMA PLUMBING,INC. TOTAL 51.25 <br /> 4407 LOCKE AVE SW <br /> COKATO,MN 55321 Payment(s) <br /> CREDIT CARD 4719 51.25 <br /> Minnesota State License#: BUIL-643774 <br /> OWNER <br /> ENQUIST,CYNTHIA <br /> 2610 WEST LAFAYETTE RD <br /> EXCELSIOR,MN 55331 <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 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 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,-f rduesc�ause. <br /> N <br /> Applicant Permitee Signature Date Issu4By Signature Date <br />