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. t <br /> CITY OF ORONO * Z 0 1 6 - 0 PJ 6 8 2 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/15/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4185 BAYSIDE RD <br /> PIN : 06-117-23-14-0012 <br /> LEGAL DESC : NORTH ARM ESTATES 3RD ADDN <br /> : LOT 002 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTENER <br /> NOTE: WATER SOFTENER <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.00 <br /> CROIX CRYSTAL WATER TREATMENT MAIL-IN FEE 2.00 <br /> 3440 YOERG DR TOTAL 53.00 <br /> HLJDSON, WI 54016- <br /> (715)386-8667 Payment(s) <br /> Minnesota State License#:plbg-WC64997 CHECK 15292 53.00 <br /> OW1vER <br /> REZABEK,ALLAN&SHIRLEY <br /> 4185 BAYSIDE RD <br /> MAPLE PLAIN,MN 55359- <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 afrer 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. <br /> � / 2�� �� ,1 _- _N__ / , � /J� /�-> <br /> , .._j , ; ;.�:� <br /> I� L � �'. <br /> t � � <br /> Applicant Permitee Signature Date Issued B�gnature Date <br />