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, , CITY OF ORONO * z 0 1 6 - 0 0 7� <br /> � 2750 KELLEY PARKWAY <br /> DATE ISSUED: 06/24/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 908 DAKOTA AVE <br /> PIN : 26-118-23-33-0022 <br /> LEGAL DESC : JOHNSTONS RGT ALBEES LONG LAKE <br /> : LOT 007 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENT[AL <br /> CONSTRUCTION TYPE : WATER HEATER <br /> NOTE: WATER HEATER <br /> VALUATION OF PLUMBING 500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 0.30 <br /> APPLIANCE CONNECTIONS, [NC. MAIL-IN FEE 2.00 <br /> 12850 CHESTNUT BLVD <br /> SHAKOPEE, MN 55379- TOTAL 52.30 <br /> (952)445-4803 Payment(s) <br /> Minnesota State License#: mech-MB004165 CHECK 8105 5230 <br /> OWNER <br /> KNUTSON, SCOTT&JULIE <br /> 908 DAKOTA AVE <br /> LONG LAKE,MN 55356- <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 separa[e <br /> permits. All provisions of laws and ordinances goveming 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 /> r , <br /> G� � �(. �� � /Z� /�� <br /> Applicant Permitee Signature Date Issued Signature Date <br />