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• CITY OF ORONO PERMIT NO.: 2009-00158 <br /> , 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE�SSUEu: 04/16/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 175 GOLDEN VIEW DR <br /> PIN : 33-118-23-43-0015 <br /> LEGAL DESC : PETERMAN 2ND ADDN <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: M[SCELLANI=,OUS YLUMB[NG REPAIKS <br /> VALUATION OF PLUMBING 1150 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> THOMPSON PLUMBING STATE SURCHARGE PLBG (VALUATION) 0.57 <br /> 15001 MINNETONKA IND. RD. <br /> MINNETONKA, MN 55345 MAIL-[N FEE 2.00 <br /> (952)933-7717 TOTAL 52.57 <br /> PAID WITH CASH 0.07 <br /> OWNER <br /> RIGLEY, J.R. <br /> 175 GOLDEN VIEW DR <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMEIVT <br /> The work for which this permit is issued shall be performcd accordin�to <br /> the approved plans and specifications,applicable Ciry approvals,and the <br /> State Building Code. This pcmlit is for only thc work described and does <br /> not grant perntission 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 confonnance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> i�l2Lu� � l l l l <br /> Applicant Permitee Signature Date Issued By � nature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCR[B A VE. <br />