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� ' � CITY OF ORONO <br /> 2750 KELLEY PARKWAY * z 0 1 7 - 0 1 1 0 4 * <br /> DATE [SSUED: 09/12/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4380 SIXTH AVE N <br /> PIN : 31-118-23-12-0018 <br /> LEGAL DESC : LJNPLATTED 31 118 23 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (3)WATER CLOSETS,(4)LAVATORIES,(1)BATHTUB,(2)SHOWERS,(1)KITCHEN SNIK,(1)DISHWASHER,(1)SILLCOCK,(i) <br /> FLOOR DRAIN,(1)WASHER,(1)WATER HEATER <br /> VALUATION OF PLUMBING 9000 <br /> APPLICANT PLUMBING FIXTURE FEE 112.50 <br /> ROYAL FLUSH INC STATE SURCHARGE PLBG(VALUATION) 4.50 <br /> 22541 TYPE CREEK TOTAL 117.00 <br /> STACY, MN 55079- Payment(s) <br /> (763)439-7845 CHECK 1201 117.00 <br /> Minnesota State License#: plbg-PC689916 <br /> OWNER <br /> MICHAEL DEMENGE&KURTIS WOLBECK <br /> 14226 NEBULA ST NE <br /> CIRCLE PINES,MN 55014- <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 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 caus <br /> �����Y V � �Z � 7 ° ?rU � i 6'Zi- <br /> Applicant Permitee Signature Date Issued B ignature Date <br />