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' ' CITY OF ORONO PERMIT NO.: 200&00051 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ISSUEn: 07/16/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2615 COUNTRYS[DE DR <br /> PIN : 04-117-23-12-0004 <br /> LEGAL DESC : COUNTRYSIDE MANOR 2ND ADDN <br /> : LOT 002 BLOCK 003 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONST.RUCTION TYPE : FIXTURES-MULT[PLE <br /> NOTE: REPLACE KITCHEN SINK,DISPOSAL AND DISHWASHER <br /> VALUATION OF PLUMBING 950 <br /> APPLICANT PLUMBING FIXTURE FEE 35.00 <br /> MANATEE PLUMBING STATE SURCHARGE PLBG(VALUATION) 0.50 <br /> 11525 199TH CIRCLE <br /> SILVERLAKE, MN 55381 MISC FEE 0.00 <br /> (612)756-1172 TOTAL 35.50 <br /> Minnesota State License#: 005923PM <br /> OWNER <br /> TICHY, PAUL& MARY <br /> 2615 COUNTRYSIDE DR <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issucd shall bc performed according to <br /> the approved plans and specitications,applicable City approvals,and the <br /> S[ate 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 speciYied 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 /> ed at any time for due c <br /> �� �� � � / / <br /> App icant Perm t S�gnature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />