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. � CITY OF ORONO * z 0 1 � - 0 0 0 7 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU25/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3265 CRYSTAL BAY RD <br /> PIN : 17-117-23-41-0014 <br /> LEGAL DESC : TOWNSITE OF LANGDON PARK <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER HEATER <br /> VALUATION OF PLUMBING 1000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.50 <br /> BENJAM[N FRANKL[N PLUMBING MAIL-IN FEE 2.00 <br /> 5718 INTERNATIONAL PKWY <br /> NEW HOPE, MN 55428- TOTAL 52.50 <br /> (612)238-9709 Payment(s) <br /> Minnesota State License#: plbg-PC643703,mech-MB004722 CREDIT CARD 0169 52.50 <br /> OWNER <br /> ERGER, MR&MRS LEROY <br /> 3265 CRYSTAL BAY RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMEIYT <br /> The work for which this permit is issued shall be performed according ro <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 I80 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 <br /> revoked at any time for due cause. <br /> � ' <br /> / ,0�5, / 7 <br /> Applicant Permitee Signature Date Issued By Si ature Date <br />