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4 <br /> CITY OF ORONO _ <br /> f 2750 KELLEY PARKWAY * DANE ISSUED: 08113/20182 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS 3240 WATERTOWN RD <br /> PIN : 32-118-23-44-0017 <br /> LEGAL DESC SENN ORONO ADDITION <br /> LOT 001 BLOCK 001 <br /> PERMIT TYPE PLUMBING(<$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURE <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 <br /> 1313 DANITA CR. MAIL-IN FEE 2.00 <br /> SHAKOPEE,MN 55379 <br /> (952)445-4803 MISC FEE 0.00 <br /> Minnesota State License#: 057209PM TOTAL 22.00 <br /> OWNER <br /> JURAN,DAVID&SHEILA <br /> 3240 WATERTOWN RD <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 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 <br /> time <br /> �for <br /> due cause. <br /> Applicant Permitee Signature Date Issued By gnature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . <br />