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CITY OF ORONO * z 0 1 2 - 0 1 z 0 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 1U26/2012 <br /> ORONO, MN 55356— <br /> ' (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3339 CRYSTAL BAY RD <br /> PI l� : 17-1 17-23-41-0021 <br /> LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B <br /> : LOT 008 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 /> LEGACY MECH SERVICES STATE SURCHARGE PLBG (VALUATION) 0.75 <br /> 9714 WOODCREST CT <br /> MONTICELLO, MN 55362- MAIL-IN FEE 2.00 <br /> (763)219-8978 MISC FEE 0.00 <br /> TOTAL 52.75 <br /> OWNER <br /> HOFER,JOHNATHAN&THERESA <br /> 3339 CRYSTAL BAY 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 specitications,applicable City approvals,and thc <br /> State Building Code. This permit is 1or 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 specitied herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenccd within 180 days of die da[e of issuance,or if construction is <br /> suspendcd for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspec[ions are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time Yor due causC <br /> ��c..Q c�v�' l l l l <br /> Applicant Permitee Signature Date [ssued L3y Sign ture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. <br />