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� CITY OF ORONO * 2 0 1 5 - 0 1 5 7 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/17/2015 <br /> ' ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 855 PARTENWOOD LA <br /> PIN : OS-117-23-34-0012 <br /> LEGAL DESC : PARTENWOOD <br /> : LOT 005 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: REPLACE 2 WATER HEATERS <br /> VALUATION OF PLUMBING 3500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.75 <br /> BENJAMIN FRANKLIN PLUMBING <br /> 5718 INTERNATIONAL PKWY TOTAL 51.75 <br /> NEW HOPE,MN 55428- Payment(s) <br /> (612)23&9709 CHECK 24113 51.75 <br /> Minnesota State License#:plbg-PC643703,mech-MB004722 <br /> OWNER <br /> GUL OR RENAE(POA), SHAIKH ASIM <br /> 855 PARTENWOOD LA <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 specificatians,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 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 /> wmmenced 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 any time for due cause. �on <br /> r'�►"' <br /> �01 i�-� �-f Ro� ��..�- `E-S� 1 z, f � , r 5 <br /> Applicant Permitee Signature Date Issued By Signature Date <br />