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` � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * z 0 1 5 - 0 0 7 4 8 * <br /> DATE ISSUED: 06/30/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 750 DICKEY LAKE DR <br /> PIN : 27-118-23-33-0008 <br /> LEGAL DESC : RINGERSWOOD <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: REPLACE WATER HEATER <br /> VALUATION OF PLUMBING 2200 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.10 <br /> BENJAMIN FRANKLIN PLUMBING MAIL-IN FEE 2.00 <br /> 1424 3RD STREET N <br /> MINNEAPOLIS, MN 55411- TOTAL 5310 <br /> (763)755-6468 Payment(s) <br /> CHECK 23319 53.10 <br /> OWNER <br /> PETERSON, GARY& DIANA <br /> 750 DICKEY LAKE DR <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 /> 5tate 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 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[ime after work has commenced. <br /> The applicant is responsible for assuring all required inspections aze <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> . <br /> � -� �� �� �� <br /> Applicant Permitee Signature Date [ssue y Signature Date <br />