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� PERMIT <br /> CITY �F ORONO Permit Number: <br /> 2750 Kelley Parkway- PO Box 66 Pos852 <br /> Crystal Bay, Minnesota 55323 Permit Type: Fixtures <br /> (952)249-4600 Date Issued: 6/16/2005 <br /> SITE ADDRESS: 565 Leaf Street Unit# <br /> Long Lake,MN 55356 <br /> P��� OS-117-23-41-0028 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Permit Class: Plumbing <br /> Pernut Type: Fixtures Pernvt Sub-type(s): Shower <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Pernrit Fee: $ 15.00 valuation: $ 0.00 <br /> State Surcharge Fee: $ 0.50 <br /> TOTAL FEE: $ 15.50 <br /> APPLICANT: Steve Santema Plumbing OWNER: Kosierazki&Fox <br /> 4407 Locke Ave SW 565 Leaf Street <br /> Cokato,MN 55321 Long Lake MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION 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 /> �'l'""`�fQ/ � �`� ' � <br /> APPLICANT PERMITEE SI NATURE - ISSUED BY SIGNATURE <br /> Copies: 1-File(SignaturesRequired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 <br />