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� CITY OF ORONO * 2 0 1 6 - 0 1 3 7 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 10/3ll2016 <br /> V ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 940 NORTH ARM DR <br /> PIN : 07-117-23-I 1-0014 <br /> LEGAL DESC : PIRATES COVE <br /> : LOT O10 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES CAME WITH THE MANUFACTURED HOME. THIS PERMIT IS FOR A PLUMBING FINAL INSPECTION <br /> OF FLOOD RIM TEST ONLY. <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.25 <br /> PRIORITY PLUMBING TOTAL 50.25 <br /> 17325 EUCLID AVE Payment(s) <br /> FARMINGTON,MN 55024- CHECK 16929 50.25 <br /> (763)292-1615 <br /> Minnesota State License#:plbg-PC644739 <br /> OWNER <br /> OLSHANSKY,ROMAN <br /> 76 KINGSVIEW LANE N <br /> PLYMOUTH,MN 55447- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued s6all be perfortned 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 dces <br /> not grant permission for additional or related work which requires sepazate <br /> permits. A(I 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at ti or due cause. <br /> � <br /> � / /D/�/ /.�j <br /> o--� )� o �, <br /> lic t ermitee Signature Date Issued gnature Date <br />