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� CITY OF ORONO PERMIT NO.: 20��00129 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUEn: 02/14/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2900 DEER RUN TR <br /> PIN : 04-117-23-24-0013 <br /> LEGA•L DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 008 BLOCK 004 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (2)WATER CLOSET,(3)LAVATORIES,(1)BATHTUB,(1)SHOWER,(2)SILLCOCKS,(1)FLOOR DRAIN,(1)SEWER EJECTOR, <br /> (1)LALINDRY TRAY,(1)WASHER AND(1)MISCELLANEOUS <br /> VALUATION OF PLUMBING 6850 <br /> APPLICANT PLUMBING FIXTURE FEE 85.63 <br /> MANATEE PLUMBING STATE SURCHARGE PLBG(VALUATION) 3.43 <br /> 11525 199TH CIRCLE <br /> SILVER LAKE,MN 55381- TOTAL 89.06 <br /> (612)756-1172 <br /> Minnesota State License#:005923PM <br /> OWNER <br /> KACZKE,ROBERT&JILL <br /> 2900 DEER RLJN TR <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 sepazate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This pertnit 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 /> oked at any time for due use. <br /> al l � l/ G�� O�l � l � <br /> Applicant P itee Signature � Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />