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� <br /> CITY OF ORONO * Z 0 1 6 - 0 0 3 7 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/14/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : ]55 GOLDEN VIEW DR <br /> PIN : 33-118-23-43-0014 <br /> LEGAL DESC : PETERMAN 2ND ADDN <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> COI�ISTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: KITCHEN SINK AND DISHWASHER <br /> VALUATION OF PLUMBING 3350 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.68 <br /> JOE'S PLUMBING&HEATING MAIL-IN FEE 2.00 <br /> 23375 DRAKE ST.N.W. <br /> ST FRANCIS,MN 55070- TOTAL 53.68 <br /> (763)427-7132 Payment(s) <br /> Minnesota State License#: BUIL-060783-PM CREDIT CARD 7726 53.68 <br /> OWNER <br /> SMITH,DOUGLAS <br /> 155 GOLDEN VIEW DR <br /> LONG LAKE,MN 55356 <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this perrnit 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 /> pern�its. 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 /> ,�-y �� �U `� �/5� �/� <br /> . <br /> Applicant Permitee Signature Date Is ed ignature Date <br />