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'� CITY OF ORONO �� <br /> 2750 KELLEY PARKWAY * � 0 1 7 - 0 0 0 7 0 * <br /> DATE ISSUED: OU24/2017 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRE � : 3115 SUSSEX RD <br /> PIN : 04-117-23-32-0015 <br /> LEGAL �S : FOX BEND <br /> � : LOT 004 BLOCK 002 <br /> PERMI '�Y : PLUMBING <br /> PROPE TY PE : RESIDENTIAL <br /> CONST UC N TYPE : FIXTURES-MULTIPLE <br /> NOTE: O WA R CLOSET,(2)LAVATORIES,(1)SHOWER <br /> VALUA I�N PLUMBING 3500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1 JS <br /> NYBO-P ERS N CO.INC. TOTAL 51.75 <br /> 6606 280 .ST ET <br /> MN 55088 Payment(s) <br /> (952)461- 749 CREDIT CARD 8865 51.75 <br /> Minnesota tate cense#:BUIL-058650,cont-MN058650 <br /> OWNER <br /> MARY SI�O DANIEL DELMORE& <br /> 3115 SUS �C <br /> LONG LA E, 55356- <br /> AG �M T AND SWORN STATEMENT <br /> The work for hvch pertnit is issued shall be perfortned according to <br /> the approved lans specifications,applicable City approvals,and the <br /> State Buildin Cbde. his permit is for on(y the work described and dces <br /> not grant pe is9ion additional or related work which requires separate <br /> permits. All ovisio of laws and ordinances goveming this type of work <br /> shall be comp d with hether or not specified herein.This permit will <br /> expire and be me nu I and void if construction suthorized is not <br /> commenced thin 18 days of the date of issuance,or if construction is <br /> suspended for peri f I80 d s at any time after work has commenced. <br /> The applicant respo ible assuring all required inspections are <br /> requested in c nform ith tate B ' de.This permit may be <br /> revoked at any time ue c /' ! <br /> �� �v � �z�� � 7 <br /> Apptic itee gnature Date Issued By ' ature Date <br />