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CITY OF ORONO I 11 H I 1 1 1 <br /> 2750 KELLEY PARKWAY <br /> * 21 7 - 0 0 1 <br /> DATE ISSUED: 07/11 3/22 017 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS : 795 OLD CRYSTAL BAY RD N <br /> PIN : 28-118-23-34-0003 <br /> LEGAL DESC : UNPLATTED 28 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : COMMERCIAL-BUSINESS <br /> CONSTRUCTION TYPE : WATER HEATER <br /> VALUATION OF PLUMBING 7000 <br /> APPLICANT PLUMBING FIXTURE FEE 87.50 <br /> STATE SURCHARGE PLBG(VALUATION) 3.50 <br /> GSD2 LLC TOTAL 91.00 <br /> 2136 SANDY LANE Payment(s) <br /> MOUND,MN 55364- CREDIT CARD 5536 91.00 <br /> Minnesota State License#:plbg-PC724024 <br /> OWNER <br /> 278,ORONO SCHOOL DIST NO. <br /> 795 OLD CRYSTAL BAY RD 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 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 time for due cause. <br /> 7 ,isi( <br /> Applicant Permitee Signature Date Iss -d Signature Date <br />