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� � CITY OF ORONO * Z 0 1 6 - 0 0 3 8 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/18/2016 <br /> ORONO, MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 755 DICKEY LAKE DR <br /> PIN : 34-118-23-22-0009 <br /> LEGAL DESC : RINGERSWOOD <br /> : LOT 005 BLOCK 002 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WATER HEATER <br /> VALUATION OF PLUMBING 600 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 030 <br /> APPLIANCE CONNECTIONS, INC. MAIL-IN FEE 2.00 <br /> 12850 CHESTNUT BLVD <br /> SHAKOPEE, MN 55379- TOTAL 52.30 <br /> (952)445-4803 Payment(s) <br /> Minnesota State License#: mech-MB004165 CHECK 7830 52.30 <br /> OWNER <br /> ESAU,TERRANCE&MARY <br /> 755 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 /> State 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 time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance wi[h the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � "e � l � CJ / V <br /> Applicant Permitee Signature Date Issued B Si nature Date <br />