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I r -, CITY OF ORONO * 2 0 1 � _ 0 0 0 8 0 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU27/2017 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 485 STUBBS BAY RD N <br /> PIN : 32-118-23-24-0003 <br /> LEGAL DESC : UNPLATTED 32 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTIOI�i TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(2)LAVATOIRES,(1)BATHTUB,(1)SHOWER <br /> VALUATION OF PLUMBING 3400 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> BOE PLUMBING STATE SURCHARGE PLBG(VALUATION) 1.70 <br /> TOTAL 51.70 <br /> 15481 KIOWA ST. Payment(s) <br /> ANDOVER,MN 55304 CHECK 4477 51.70 <br /> (763)757-1991 <br /> Minnesota State License#:plbg-MB3984 <br /> OWNER <br /> WILL,JOHN&JOCLYN <br /> 485 STUBBS 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 dces <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 l SO days at any time after work has commenced. <br /> The applican responsible for assuring all required inspections are <br /> requested i onformance with the State Building Code.This permit may be <br /> revoked a ime for cause. <br /> C` Z��� / �� �i l <br /> Applicant Permitee Signature Date Issued B ignature Date <br />