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� • <br /> CITY OF ORONO * z 0 1 7 - 0 1 1 8 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/25/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2725 PHEASANT RD <br /> PIN : 21-117-23-23-0024 <br /> LEGAL DESC : PHEASANT LAWN <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : REPAIR <br /> VALUATION : $ 1,900.00 <br /> NOTE: WATER AND SANITARY PIPING ALTERATIONS <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> TIM'S QUALITY PLUMBING STATE SURCHARGE(VALUATION) 0.95 <br /> 523 CENTRAL AVE TOTAL 50.95 <br /> P.O.BOX 29 Payment(s) <br /> OSSEO,MN 55369 CHECK 5494 50.95 <br /> (763)424-3258 <br /> Minnesota State License#:plbg-PC643755,mech-MB004663 <br /> OWNER <br /> JORGENSEN,CHMICHAEL&MARGARET <br /> 2725 PHEASANT RD <br /> EXCELSIOR,MN 55331- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifica[ions,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 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 /> revoked at any time for due cause. <br /> %��,� ,-�---,�-��- �� � �� �e 9 � s, �,7 <br /> Applicant Permitee Signature Date Issued B ignature Date <br />