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r �► <br /> CITY OF ORONO PERMIT NO.: 2009-00497 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 08/18/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1165 WYNDMERE RD <br /> PIN : 26-118-23-41-0010 <br /> LEGAL DESC : WYNDMERE <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: PLUMBER INSTALLING WATER METER PURCHASED BY KOTHRADE TO INSTALL AS PART OF NEW SEPTIC SYSTEM <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> VETSCH PLUMBING SERVICES STATE SURCHARGE PLBG(<$500) 0.50 <br /> 2451 LACHAMAN AVE.N.E. <br /> MN 55376- MAIL-IN FEE 2.00 <br /> (763)497-9733 TOTAL 17.50 <br /> Minnesota State License#: 7375 <br /> OWNER <br /> HONG,BACK <br /> 1165 WYNDMERE RD <br /> WAYZATA,MN 55391- <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 S B ilding Code.This permit may be <br /> revoked at any time for due cau <br /> Applicant Perm -1 /.' I/_';�'�x A,A-) S / /8'/119 <br /> itee Signature Date I 11-y-Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />