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CITY OF ORONO 1111 Ill III 111111111111 II <br /> 2750 KELLEY PARKWAY * 20 1 6 - 0 1 2 7 <br /> DATE ISSUED: 10/11 8/2016 <br /> ORONO, MN 55356- <br /> - (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 993 WILDHURST TR <br /> PIN : 07-117-23-12-0003 <br /> LEGAL DESC : UNPLATTED 07 117 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: REPLACE:DISHWASHER <br /> VALUATION OF PLUMBING 1000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> ECOWATER STATE SURCHARGE PLBG(VALUATION) 0.50 <br /> 3208 FIRST STREET S MAIL-IN FEE 2.00 <br /> WAITE PARK,MN 56387- TOTAL 52.50 <br /> (320)251-2505 Payment(s) <br /> Minnesota State License#:plbg-PC643402 CREDIT CARD 0033 52.50 <br /> OWNER <br /> PFAFF,BRAD <br /> 993 WILDHURST TR <br /> MOUND, MN 55364- <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 for due cause. l / I p <br /> ( r\CA; <br /> u <br /> 10, 1k, 1 ( ' <br /> Applicant Permitee Signature Date Issued By Signature Date <br />