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i <br /> CITY OF ORONO * z 0 1 7 - 0 0 4 7 0 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: OS/09/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1003 COX FARM RD <br /> P[N : 27-118-23-33-0014 <br /> LEGAL DESC : SHADOWOOD FARM <br /> : LOT 002 BLOCK 002 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER SOFTENER <br /> NOTE: REPLACE WATER SOFTNER <br /> VALUATION OF PLUMBING 650 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> BRACKETT,JOHN STATE SURCHARGE PLBG(VALUATION) 0.33 <br /> 1003 COX FARM RD TOTAL 50.33 <br /> LONG LAKE,MN 55356- Payment(s) <br /> CREDIT CARD 0047 5033 <br /> OWNER <br /> BRACKETT, JOHN <br /> 1003 COX FARM RD <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 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 atter work has commenced. <br /> The applicant is responsible for assuring alI required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any Fime for dqe c�se. ^ �'^� <br /> ; ,� _ <br /> �C.�� <br /> , �, ` �- <br /> 5 � �� �.'���..� �� ��..,��f- ��� , , �� ,�.,. <br /> A licant Permit e S' n re Date � <br /> pp [ssu�d By Signature Dat� <br />