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. • <br /> CITY OF ORONO PERMIT NO.: 2008-00293 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEu: 10/13/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2715 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 003 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: <br /> REPLACE: (1)KITCHEN SINK,(1)DISPOSAL,AND(2)DISHWASHERS <br /> VALUATION OF PLUMBING 2400 <br /> APPLICANT PLUMBING FIXTURE FEE 35.00 <br /> STEWART PLUMBING, INC. STATE SURCHARGE PLBG(VALUATION) 1.20 <br /> 13025 GEORGE WEBER DR. SUITE#1 TOTAL 36.20 <br /> ROGERS, MN 55374 <br /> (763)428-1833 <br /> Minnesota State License#: 061344 PM <br /> OWNER <br /> WILSON, MARK& KIRSTIN <br /> 2715 COUNTRYSIDE DR W <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 E3uilding Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires sepazate <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 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 cause. <br /> -�%'� ��'-'� j � l ( 5 / �i b-' /l� /�� l D(� <br /> Applicant Permitee Signature Date Iss d By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />