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' CITY OF ORONO * Z 0 1 S - 0 1 0 6 2 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 08/20/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 140 HACKBERRY HILL <br /> PIN : 33-118-23-44-0005 <br /> LEGAL DESC : DANIELS LONG LAKE HEIGHTS <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOIY TYPE : WATER SOFTNER <br /> VALUATION OF PLUMBING 1100 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.55 <br /> ROBERT B. HILL CO. MAIL-IN FEE 2.00 <br /> 7101 OXFORD STREET <br /> MINNEAPOL[S,MN 55426- TOTAL 52.55 <br /> (952)925-1444 Payment(s) <br /> Minnesota State License#: BUIL-WC646096 CHECK 048256 52.55 <br /> OWNER <br /> ETAL,LAWRENCE GLEASON <br /> 140 HACKBERRY HILL <br /> LONG LAKE, MN 55356 <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 no[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 conformance with the State Building Code.This permit may be I� <br /> revoked at any time for due cause. <br /> � r <br /> � �i�-�l i U ��i�j� (� <br /> ti c�.c 1 � <br /> Applicant Permitee Signatur Date Issued By Signature Date <br />