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CITY OF ORONO * Z 0 1 6 - 0 0 0 6 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU19/2016 <br /> '' ORONO, MN 55356- <br /> � (952 249-4600 FAX: 952) 249-4616 <br /> ADDRESS : 1199 ELMWOOD AVE <br /> PIN : 07-117-23-14-0059 <br /> LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RES[DENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: REPAIRS OF: 1 WATER CLOSET, 1 LAVATORY, 1 SHOWER, 1 MISCELLANEOUS <br /> VALUATION OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> SICORA INC STATE SURCHARGE PLBG(VALUATION) 1.25 <br /> 5601 WEST LAKE STREET MAIL-IN FEE 2.00 <br /> ST LOUIS PARK,MN 55416- TOTAL 53.25 <br /> (952)929-0098 Payment(s) <br /> Minnesota State License#: BUIL-BC253425 CREDIT CARD 0973 53.25 <br /> OWNER <br /> HARVEY,MR.&MRS. <br /> 1199 ELMWOOD AVE <br /> MOUND, MN 55364- <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 onty the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of Iaws 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 /> �,. <br /> revoked at any time for due cause. � �l�J <br /> �-L- - �1 �����' � r <br /> i � � l U, <br /> Applicant Permitee Signature Date Issued By Signature Date <br />