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- ' CITY OF ORONO * Z 0 1 7 - 0 0 4 3 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/02/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1885 CONCORDIA ST <br /> PIN : 17-117-23-23-0002 <br /> LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURE <br /> NOTE: WATER SOFTENER <br /> VALUATION OF PLUMBING 490 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.25 <br /> RICHARD GRASSIE INC. TOTAL 50.25 <br /> 6121 EXCELSIOR BLVD <br /> SUITE 206 Payment(s) <br /> MINNEAPOLIS,MN 55416- CHECK 14560 50.25 <br /> OWNER <br /> KAISER, BERNARD&CAROLYN <br /> 2855 PROVIDENCE PLACE <br /> INDEPENDENCE, MN 55359- <br /> AGREEMENT AND SWORN STATEME1vT <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 80 days at any time after work has commenced. <br /> The applicant is respon le for assuring all required inspections are <br /> requested in confor ce with the State Building Code.This permit may be <br /> revoked at any ti or du�aause. , <br /> % � / <br /> i , <br /> � �' ���' � s� � � a �l� <br /> Ap icant Per it e Signature e [ssued B ignature Date <br />