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� <br /> CITY OF ORONO * 2 0 1 2 - 0 0 9 3 3 * <br /> � 2750 KELLEY PARKWAY DATE ISS�JED: 09/17/2012 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1856 SHADYWOOD RD <br /> PIN : 17-117-23-24-0017 <br /> LEGAL DESC : SHADY-WOOD <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 1400 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> BENJAMIN FRANKLIN PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.70 <br /> 1424 3RD STREET N <br /> MINNEAPOLIS,MN 55411- MAIL-IN FEE 2.00 <br /> (763)755-6468 TOTAL 52.70 <br /> OWNER <br /> SEIFERT,MILTON <br /> 1856 SHADYWOOD 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 /> permiu. 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 aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> l l �?�y "_ _'�. l l <br /> Applicant Permitee Signature Date Issue S gnature te <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. <br />