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r CITY OF ORONO PERMIT NO.: 2010-00487 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- �ATE ►ssuEn: 06/16/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2001 SUGARWOOD DR <br /> PIN : 34-118-23-21-0009 <br /> LEGAL DESC : SUGAR WOODS <br /> : LOT 001 BLOCK 002 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES- MULTIPLE <br /> NOTE: <br /> (1)WATER CLOSGT,(2)LAVATORES,AND(l)BATHTUB <br /> VALUATION OF PLUMBING 9000 <br /> APPLICANT PLUMBING FIXTURE FEE 112.50 <br /> SCHULTIES PLUMBING STATE SURCHARGE PLBG(VALUATION) 4.50 <br /> 1521 94TH LANE NE <br /> BLAINE, MN 55449 TOTAL 117.00 <br /> (651)786-4007 <br /> Minnesota State License#: 058799PM <br /> OWNER <br /> BALAN, TODD&ALISON <br /> 2001 SUGARWOOD DR <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 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 I80 days of[he 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 /> �� �i�� � l l6 i �� `� ��if,Gt��� ,�P � � C] <br /> Applicant Permitee Signature Date Iss e y Signature Date � <br /> SEPARATE PERMITS REQUIRED FOR WORK O HER THAN DESCRIBED ABOVE. <br />