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+ CITY OF ORONO * z 0 1 7 - 0 0 2 4 3 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 03/15/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1900 LAKEVIEW TER <br /> PIN : 27-118-23-42-0008 <br /> LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN <br /> : LOT 003 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: REPLACING AND BRINGING SHOWER UP TO CODE <br /> VALUATION OF PLUMBING 2000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.00 <br /> RICHFIELD PLUMBING CO. INC. TOTAL 51.00 <br /> 8640 HARRIET AVE S- SUITE#10 <br /> BLOOMINGTON,MN 55420- Payment(s) <br /> �� CHECK 18841 51.00 <br /> OWNER <br /> KOSCIOLEK, MR. &MRS. <br /> 1900 LAKEVIEW TER <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 /> pem�its. All provisions of laws and ordinances governing diis 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 I 80 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 ca e. � �� <br /> �l/ ' � , <br /> �� �� � 7 �;�� �.��.1 i>���s, �> � � ��_� �-, <br /> Applican ermitee Signature .= ate Issued By Signature Date <br />