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PERMIT <br /> C�TY OF ORONO PERMIT TYPE: <br /> 2750 Kelley Parkway- P.O. Box 66 E`�-.0ME:I <br /> Crystal Bay, Minnesota 55323 <br /> Permit Number: {�1�_;5 <br /> (612)473-7357 Date Issued: 0':-!tD7 6" <br /> SITE ADDRESS: <br /> 1 TRIJFFiSLA TFC <br /> CH <br /> DESCRIPTION: <br /> VAC�JUM BREAKER <br /> Plumbing PNS mit Type VACIJUM BREAf:ER <br /> Plumbing Work Type RESIDENCE <br /> REMARKS: <br /> FEE SUMMARY: <br /> VALtiAT I ON $ 00 <br /> Base Fee .00 <br /> — <br /> Total Fee =;550 <br /> CONTRACTOR: _ Applicant. _ OWNER: <br /> GENERAL PL-t JM61 viii & HEAT I NC; ARNEM 1 K'E <br /> 5541 Ht�;Y 1 SE 1.i, �-Pt JFFi ILA 'FR <br /> D LANO int,[ c c'_,•:_ ; f_IFjONO MN E=56 <br /> (612) 479-34167 <br /> THE �ENDERS I GNED HEREBY REtWEST . FERMI SSI ON TO EKE +iE ME- ENT; <br /> SPECIFIED AND AGREES TO D131ALL 1 )RK I N �r It T C PL INCL b�i � ALL .CITY F <br /> L_ <br /> ORONO ORDINANCES ANCA STATE I�F <br /> APPLICANT/PE MI EE SIGNATURE ISSUED BY:SIGNATURE <br />