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� PERMIT <br /> CIT,�.. OF ORONO Permit Number: <br /> 2�t�0 Kelley Parkway - PO Box 66 P06964 <br /> Crystal Bay, Minnesota 55323 Permit Type: FiX�res <br /> (952) 249-4600 Date Issued: l0�30�2003 <br /> SITE ADDRESS: 3720 Jacobs Mill Rd <br /> Long Lake,MN 55356 <br /> P I D: 32-118-23-24-0008 <br /> DESC RI PTION: <br /> Proposed Use: Kesicientiai <br /> Pernut Class: Plumbing <br /> Permit Type: Fixtures Pernut Sub-type(s): Multiple Fixtures <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate pernuts required: <br /> NOTICES/REMARKS: <br /> Homeowner taking out permit-recommended that contractor pull-said this was ok <br /> FEE SUMMARY: Pernut Fee: $ 171.03 Valuation: $ 13,682.00 <br /> State Surcharge Fee: $ 6.84 <br /> TOTAL FEE: $ 177.87 <br /> APPLICANT: Owner/Self OWNER: Greg Carlson <br /> � 521 Willow Dr.N.#203 <br /> Long Lake,MN 55356 <br /> THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED <br /> AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF <br /> MINNESOTA BUILDING CODE REQUIREMENTS. <br /> ��-`z � � �n c.� n /� <br /> ,f �� � <br /> A LICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE <br /> Copies: 1-File(SiQnitures Required), 1-Aqplicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 <br />