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CITY OF ORONO * z 0 1 4 - 0 0 1 7 z * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/26/2014 <br /> ORONO, MN 55356- <br /> � (952 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3568 BAYSIDE RD <br /> PIN : OS-117-23-13-0041 <br /> LEGAL DESC : AUDITOR'S SUBD.NO. 203 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 1500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG (VALUATION) 0.75 <br /> BENJAMIN FKANKLIN PLUMBING MAIL-IN FEE 2.00 <br /> 1424 3RD STREET N <br /> MINNEAPOLIS, MN 5541 1- TOTAL 52.75 <br /> (763)755-6468 Payment(s) <br /> CHECK 21 13] 52.75 <br /> OWNER <br /> BARTLETT,JEFFERY & JOANNE <br /> 3568 BAYSIDE RD <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work for which this permit is issued shall be performed according to <br /> the approved plans and specitica[ions,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 separatc <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 Yor a period of 1 AO days at any time after work has commenced. <br /> The applicant is responsible tbr assuring all required inspections are <br /> requcsted in conformance with the State Quilding Code.This permit may be <br /> revoked at any time for due cause. <br /> �� / / <br /> Applicant Permitee Signature Date Issued By ignature Date <br />