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1 � <br /> CITY OF ORONO * Z 0 1 5 - 0 1 2 5 4 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/29/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 1480 GREEN TREES RD <br /> PIN : 11-117-23-23-0016 <br /> LEGAL DESC : GREEN TREES ON TANAGER LAKE <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: KITCHEN SINK,DISPOSAL,DISHWASHER <br /> VALUATION OF PLUMBING 3500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> FREEDOM MECHANICAL STATE SURCHARGE PLBG(VALUATION) 1.75 <br /> 8382 172ND AVE SE TOTAL 51.75 <br /> BECKER, MN 55308- Payment(s) <br /> (612)363-6190 CHECK 7176 51.75 <br /> Minnesota State License#: mech-004042PM <br /> OWNER <br /> WILLSON,CHRIS& SARAH <br /> 1480 GREEN TREES RD <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according[o <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 goveming[his 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 afrer 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 /> � . <br /> ` 2l" � �v�� �� � la 5 / /5 <br /> � <br /> Applicant Permitee Signature Date Iss ed Signature Date <br />