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• CITY OF ORONO * 2 0 1 3 - 0 0 3 0 2 * <br /> � 2750 KELLEY PARKWAY DATE ISSUED: 04/30/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 4320 SIXTH AVE N <br /> PIN : 31-118-23-12-0009 <br /> LEGAL DESC : SHARON HILLS <br /> : LOT 004 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: INSTALL DISHWASHER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 <br /> APPLIANCE INSTALLERS OF MN INC. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 14105 RUTGERS ST.NE <br /> PRIOR LAKE,MN 55372- MAIL-IN FEE 2.00 <br /> (952)469-8341 TOTAL 22.00 <br /> OWNER <br /> COLEMAN,JOHN&CAROL <br /> 4320 SIXTH AVE N <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 specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not gant permission for additional or related work which requires sepazate <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 aze <br /> requested in conformance witl�the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> �l�'LLl�C-� L7L / / l l <br /> Applicant Permitee Signature Date Issue By ignature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />