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�'� PERMIT <br /> C��•`i( OF ORONO Permit Number: <br /> 2750 Kelley Parkway- PO Box 66 P08125 <br /> Crystal Bay, Minnesota 55323 Permit Type: Fixtures <br /> (952) 249-4600 Date Issued: 10/26/2004 <br /> SITE ADDRESS: 3640 Jacobs Mill Rd <br /> Long Lake,MN 55356 <br /> PID: 32-118-23-24-0010 <br /> DESCRIPTION: <br /> Proposed Use: Kesiclenrial <br /> Permit Class: Plumbing <br /> Pernut Type: Fixtures Pernut Sub-type(s): Multiple Fixtures <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Pernut Fee: $ 431.25 Valuation• $ 34,500.00 <br /> State Surcharge Fee: $ 17.25 <br /> TOTAL FEE: $ 448.50 <br /> APPLICANT: Thompson Plumbing OWNER: Matt vanslooten <br /> 15001 Minnetonka Ind.Rd. 3640 Jacobs Mill Rd <br /> Minnetonka,MN 55345 Long Lake,MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERNIISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> � <br /> � ;d�.e <br /> G��G/�� �c-G2�rv <br /> APPLICANT PERMITEE SIGATAT�[IRE ISSUED BY SIGNATURE <br /> �� <br /> Conies: 1-File(SiQnitures Required), 1-Auulicant, 1-Monthlv Renorts, 1-Assessine. 1-Finance Page 1 <br />