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. CITY OF ORONO * z 0 1 6 - PJ PJ 9 1 8 * <br /> . 2750 KELLEY PARKWAY DATE ISSUED: 08/03/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (9_52) 249-4616 <br /> ADDRESS : 425 FERNDALE RD N <br /> PIN : 36-1 18-23-14-0014 <br /> LECAL DESC : HAUSER LAUER WCC ADDN <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER HEATER <br /> VALUATION OF PLUMBING 2582 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.29 <br /> CITY VIEW PLUMBING& HEATING TOTAL S1.29 <br /> 1880-B WAYZATA BLVD W <br /> P.O. BOX 150 Payment(s) <br /> LONG LAKE, MN 55356 CHECK 36406 51.29 <br /> (952)473-8793 <br /> Minnesota State License#: plbg-MB005208 <br /> OWNER <br /> HAUSER, HELEN <br /> 425 FERNDALE RD N <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 Cor only the work described and does <br /> not grant permission for additional or related work N hich requires separate <br /> permits. All provisions of IaN°s and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> eapire 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 I 80 days at any time afier H�ork has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance��°ith the State Building Code.This permit may be <br /> revoked n'v'time for due cause. <br /> �� --E g <br /> `� 3 r �-� �v , �- � <br /> pplicant Permitee Signature Date Issued B, ignature Date <br />