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� <br /> CITY OF ORONO * 2 0 1 z - 0 0 6 8 7 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 07/18/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 10 MYRTLEWOOD RD <br /> PIN : 36-118-23-33-0009 <br /> LEGAL DESC : MYRTLEWOOD <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : VACUUM BREAKER <br /> NOTE: VACUUM BREAKER FOR LAWN SPRINKLER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> DUDA PLUMBING STATE SURCHARGE PLBG(<$500) 5.00 <br /> 208 17TH AVE.N. TOTAL 20.00 <br /> HOPKINS,MN 55343- <br /> (612)695-0845 <br /> OWNER <br /> FREELAND,BRYAN <br /> 10 MYRTLEWOOD RD <br /> WAYZATA,MN 55391- <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 goveming 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 /> evoked at any time for due cause. <br /> � ��l��� _ T i � g' i r� i i <br /> �licant Permrte ignature Date Issued By S' ature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER N DESCRIBED ABO . <br />