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t � <br /> CITY OF ORONO * 2 PJ 1 4 — 0 0 7 0 0 * <br /> 2750 KF.LLEY PARKWAY DATE ISSUF.D: 07/07/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 940 DAKOTA AVE <br /> PIN : 26-118-23-33-0016 <br /> LEGAL DESC : JOHNSTONS RGT ALBEES LONG LAKE <br /> : LOT 001 BLOCK 000 <br /> PERMIT TYPE : PLUMBING (% $500) <br /> PRONERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES - MUI_"T�IPI.E <br /> NC)�Il�:: Pl.l_'�'�1I3ING FIXTI'RES: <br /> (1)WATF?R CLOSt?�T.(1)LAVA�I�ORY.(I) SHOw'I�:R. (I)L�11�NI)RY�I�RAY AND(I)W�1SHI;R <br /> VALUATION OF PLUMB[NG 1500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> COX PLUMBING LLC STATE SURCHARGE PLBG (VALUATION) 0.75 <br /> 17041 172ND AVE SF. TOTAL 50.75 <br /> BIG LAKE, MN 55309- Payment(s) <br /> (612)242-9247 CHECK 5394 50.75 <br /> Minnesota State L.icense#: plbg-59474 <br /> OWNER <br /> DIERINGER, M�T"[�}��iEW& 'I�AMI <br /> 940 DAKOZ�A AVE <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> I�he work Yor which this permit i�issucd shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and thc <br /> State Buildin�Code. This pem�it is for only the ti�ork describcd and does <br /> not grant permission for additional or related work which requires separatc <br /> permits. All provisions of laws and ordinances governing this type of work <br /> tihall be compied���ith N�hether or not specitied herein.This permit will <br /> cxpire and become null and void if construction authorizcd is not <br /> commenecd within 180 days of thc 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 assurine all requircd inspections are <br /> requested in conformance widi the State Building Codc This permit ma}�bc <br /> revoked at anv time for due causc. <br /> � 7-��5� 7/ 7 / / � <br /> Ap i ant Permitec S'>natur� Date Issued Signalure Datr <br />