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CITY OF ORONO * 2 0 1 4 - 0 0 1 7 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 02/26/2014 <br /> • ORONO, MN 55356- <br /> (952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 380 LEAF ST <br /> PIN : 04-117-23-23-0027 <br /> LEGAL DESC : AUDITOR'S SUBD.NO.230 <br /> : LOT 026 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (2)WATER CLOSETS,(2)LAVATORIES,(2)SHOWERS <br /> VALUATION OF PLUMBING 5250 <br /> APPLICANT PLUMBING FIXTURE FEE 65.63 <br /> STATE SURCHARGE PLBG(VALUATION) 2.63 <br /> FREEDOM MECHANICAL TOTAL 68.26 <br /> 8382 172ND AVE SE Payment(s) <br /> BECKER, MN 55308- CREDIT CARD 4420 68.26 <br /> (612)363-6190 <br /> Minnesota State License#:mech-004042PM <br /> OWNER <br /> BURKE,FORREST&RENEE <br /> 380 LEAF ST <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 /> permiu. 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 conformance with the State Building Code.This permit may be <br /> revoked time for due cause. <br /> ��li,��� ,2-�..-�-/Y oZ i� i <br /> Applicant Permitee Signature Date Iss d By Signature Date <br />