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CITY OF ORONO * z B l z - 0 i 1 3 3 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/07/2012 <br /> r ORONO, MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS 1560 TANGLEWOOD RD <br /> PIN 26-118-23-32-0012 <br /> LEGAL DESC TANGLEWOOD <br /> LOT 003 BLOCK 001 <br /> PERMIT TYPE PLUMBING(<$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : VACUUM BREAKER <br /> NOTE: 1"VACUUM BREAKER <br /> APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 <br /> EASCO PLUMBING&HEATING INC. STATE SURCHARGE PLBG(<$500) 5.00 <br /> 7965 PIONEER TR <br /> LORETTO,MN 55357 TOTAL 20.00 <br /> (612)369-5486 PAID WITH CC# 3448 <br /> OWNER <br /> BUHMAN,DION&TANYA <br /> 1560 TANGLEWOOD RD <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 t any time after work has commenced. <br /> The applicant is respo a for assurin II required inspections are <br /> requested i an <br /> with the State uilding Code.This permit may be <br /> revok at ime for due cause. <br /> plic t Pe ' Signature Date Issuedby Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />