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a • CITY OF ORONO PERMIT NO.: 2010-00024 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: OU20/2010 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 395 SUSSEX LA <br /> PIN : 04-117-23-24-0007 <br /> LEGAL DESC : FOX BEND <br /> : LOT 006 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES - MULTIPLE <br /> NOTG: PLUMBING FIXTURES <br /> (1)WATER CLOSET,(2)LAVA"CORIES,(1)E3ATHTUB,(1)SHOWER AND(1)STEAM GENERATOR <br /> VALUATION OF PLUMBING 5000 <br /> APPLICANT PLUMBING FIXTURE FEE 62.50 <br /> PAVEK PLUMBING STATE SURCHARGE PLBG (VALUATION) 2.50 <br /> 4550 COUNTY RD 10 N <br /> WATERTOWN, MN 55388 TOTAL 65.00 <br /> �) <br /> Minnesota State License#: 60617-PM <br /> OWNER <br /> CAMPBELL,JON& SUSAN <br /> 395 SUSSEX LA <br /> LONG LAKE, MN 55356 <br /> AGREEMENT AND SWORIY 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 E3uilding 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 governing this type of work <br /> shali 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 atter work has commenced. <br /> 'I'he applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked a time for due cause. <br /> � �� G��'�- /l 2�� 2�/C-� <br /> Applicant Permitee �gnature Date Issue y Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />