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CITY OF ORONO PERMIT NO.: 2011-01144 <br /> • 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE IssuEv: 09/29/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1205 DICKENSON ST <br /> PIN : 02-117-23-31-0040 <br /> LEGAL DESC : MINNETONKA BLUFFS <br /> : LOT 000 BLOCK Ol6 <br /> PERMIT TYPE : PLUMBING(> $500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> VALUATION OF PLUMBING 8000 <br /> APPLICANT PLUMBING FIXTURE FEE 100.00 <br /> GRABOW PLUMBING, 1NC. STATE SURCHARGE PLBG (VALUATION) 4.00 <br /> 8420 REDWOOD STREET <br /> COON RAPIDS, MN 55433 MAIL-IN FEE 0.00 <br /> � MISC FEE 0.00 <br /> Minnesota State License#: 038623PM TOTAL 104.00 <br /> OWNER <br /> WOTIPKA, LINDA A& LEE A <br /> 9908 NW 20TH ST <br /> PEMBROKE PINES, FL 33024 <br /> AGREEMENT AIVD 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 Buildin�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 or laws and ordinances governing this type of work <br /> shail 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 anv time for due cause. <br /> �2✓�Gs� �ja, G� �►' l.?y l /� • ,,�.�y�L.c. (1 iYh lC�l (..�'�v"1 / l,��J l �/ <br /> Applicant Permitee Signature Date Issued�By S�gnature � Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />