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^ CITY OF ORONO * 2 0 1 7 - 0 PJ 0 4 5 * <br /> • 2750 KELLEY PARKWAY DATE ISSUED: OUi9/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS : 2685 SHADYWOOD RD <br /> PIN : 21-117-23-23-0050 <br /> LEGAL DESC : REG.LAND SURVEY NO. 1453 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WATER HEATER&MIXING VN <br /> VALUATION OF PLUMBING 4100 <br /> APPLICANT PLUMBING FIXTURE FEE 51.25 <br /> STATE SURCHARGE PLBG(VALUATION) 2.05 <br /> BENJAMIN FRANKLIN PLUMBING MAIL-IN FEE 2.00 <br /> 5718 INTERNATIONAL PKWY <br /> NEW HOPE,MN 55428- TOTAL 55.30 <br /> (612)238-9709 Payment(s) <br /> Minnesota State License#:plbg-PC643703,mech-MB004722 CREDIT CARD 0169 55.30 <br /> OWNER <br /> BROWN,RICHARD W&MARION H <br /> 2685 SHADYWOOD RD <br /> ,MN 55331- <br /> AGREEMENT AIYD SWORN STATEMENT <br /> The work for which this pertnit 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 dces <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 /> revoked at any time for due cause. _ n„„ <br /> /(,{Cl <br /> �' YIa� I ��` �� n�� 1 , �9 , ,� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />