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� � � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * � 0 1 6 - 0 1 4 8 2 * <br /> DATE ISSUED: 1 U28/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 3405 H[GH LA <br /> PIN : OS-117-23-I1-0019 <br /> LEGAL DESC : GRAHAM H[LL PRESERVE 2ND ADD[T[ON <br /> : LOT 2 BLOCK 1 <br /> PERM[T TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : WATER SOFTENER <br /> NOTE: REPLACE WATER SOFTENER <br /> VALUATION OF PLUMBING 1000 <br /> APPLICANT PLUMBING F[XTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.00 <br /> CROIX CRYSTAL WATER TREATMENT MAIL-IN FEE 2.00 <br /> 3440 YOERG DR <br /> HUDSON, WI 54016- TOTAL 53.00 <br /> (715)386-8667 Payment(s) <br /> Minnesota State License#:plbg-WC64997 CHECK 15872 53.00 <br /> OWNER <br /> REILLY, KEVIN&DENISE <br /> 3405 HIGH LA <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AIYD 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 /> shail 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 I 80 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 /> C a.c, <br /> �� ��� ' � �v l l i��i �� <br /> Applicant Permitee Signature — Date Issued By, � nature Date <br />