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CITY OF ORONO PERMIT <br /> Permit Number: <br /> 2750 Kelley Parkway - PO Box 66 P08300 <br /> Crystal t3ay Minnesota 55323 Permit Type: Fixtures <br /> (952) 249-4600 Date Issued: 12/17/2004 <br /> SITE ADDRESS: 925 Old Long Lake Rd <br /> Wayzata,MN 55391 <br /> PID: 35-118-23-41-0005 <br /> DESCRIPTION: <br /> Proposed Use: Residential <br /> Permit Class: Plumbing <br /> Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures <br /> DETAILS: <br /> Approved per resolution#: <br /> Separate permits required: <br /> NOTICES/REMARKS: <br /> FEE SUMMARY: Permit Fee: $ 187.50 <br /> Valuation: $ 15,000.00 <br /> State Surcharge Fee: $ 7.50 <br /> TOTAL FEE: $ 195.00 <br /> APPLICANT: Riverview Plumbing(See Comments) OWNER: Mr. &Mrs.Darrell Anderson <br /> P.O.Box 387 925 Old Long Lake Rd <br /> 823 Vernon Avenue Wayzata MN 55391 <br /> Elk River,MN 55330 <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 /> _Ago <br /> • ''Mr,_< ' ' E SIGNATURE ISSUEb BY SIGNATURE <br /> Copies: 1-File(Si&nitures Required). 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1 <br />