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- CITY OF ORONO * Z 0 1 4 - 0 0 PJ 4 5 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OU15/2014 <br /> ORONO, MN 55356- <br /> (952 249-4600 FAX: (952 249-4616 <br /> ADDRESS : 2605 MAPLERIDGE LA <br /> PIN : 21-117-23-21-0005 <br /> LEGAL DESC : SHORE HILLS <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET <br /> (1)SHOWER <br /> (2)LAVATORIES <br /> VALUATION OF PLUMBING 6000 <br /> APPLICANT PLUMBING FIXTURE FEE 75.00 <br /> STATE SURCHARGE PLBG(VALUATION) 3.00 <br /> GRABOW PLUMBING, INC. TOTAL 78.00 <br /> 8420 REDWOOD STREET Payment(s) <br /> COON RAPIDS, MN 55433 CHECK 14844 78.00 <br /> �) <br /> Minnesota State License#: BUIL-038623PM <br /> OWNER <br /> PAULSON,ERIC <br /> 2605 MAPLERIDGE LA <br /> EXCELSIOR,MN 55331- <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 with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> /���G���- /�iJ'�/��_ � / /�S l/ <br /> pplicant Permitee Signature ate Issu By Signature Date <br /> I <br />