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' CITYOFORO O * z015 - 00027 * <br /> � 2750 KELLEY PA WAY pATE [SSOE�: OU12/2015 <br /> ORONO, MN 553 6- <br /> 952 249-4600 FAX: 95 249-4616 <br /> ADDRESS : 75 BAYSIDE TR <br /> PIN : 06-117-23-22-0030 <br /> LEGAL DESC : BAYSIDE MEADOWS <br /> : LOT 5 BLOCK 1 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: 1 IRON FILTER <br /> VALUATION OF PLUMBING 1900 <br /> APPLICANT PLUMBIN FIXTURE FEE 50.00 <br /> STATE SU CHARGE PLBG(VALUATION) 130 <br /> BERGERSON-CASWELL INC. <br /> 5115 INDUSTRIAL ST. TOTAL 51.30 <br /> MAPLE PLAIN, MN 55359 Payment(s) <br /> (763)479-3121 CHECK 41301 51.30 <br /> OWNER <br /> Gonyea Homes <br /> 6102 GOLDEN VALLEY ROAD <br /> GOLDEN VALLEY, MN 55427- <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 goveming 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 u . J(f) <br /> t <br /> .�'�, l�__ l�� L.L �`� �L �.��r \ � � � �� ��� <br /> Applicant Permitee Signature Date [ssued By ignature Date <br />