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„ CITY OF ORONO III I HI IM 11 II HI ll I III II <br /> 43 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 03/04/2013 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 960 WILLOW DR N <br /> PIN : 27-118-23-33-0011 <br /> LEGAL DESC : UNPLATTED 27 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: DISHWASHER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE INSTALLERS OF MN INC. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 14105 RUTGERS ST.NE <br /> PRIOR LAKE,MN 55372- MAIL-IN FEE 2.00 <br /> (952)469-8341 TOTAL 22.00 <br /> OWNER <br /> BODE,KATHRYN <br /> 960 WILLOW DR 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 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 y time for due cause. <br /> / / / / <br /> Applica PerTnitee Signature Date Issued y S nature , Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A:'i VE. <br />