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� � ' CITY OF ORONO PERMIT NO.: 20�2-000s9 <br /> 2750 KELLEY PARKWAY <br /> ORONO, MN 55356- DATE ISSUED: OU27/2012 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADD ESS : 3190 SUSSEX RD <br /> PIN : 04-117-23-32-0007 <br /> LEG L DESC : FOX BEND <br /> : LOT 001 BLOCK 001 <br /> PER IT TYPE : PLUMBING(>$500) <br /> PRO ERTY TYPE : RESIDENTIAL <br /> CON TRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE PLUMBING FIXTURES: <br /> (1)E H-WATER CLOSET,LAVATORY,KITCHEN SINK,DISPOSAL,DISHWASHER AND LAUNDRY TRAY <br /> VAL ATION OF PLUMBING 5000 <br /> APPLICANT PLUMBING FIXTURE FEE 62.50 <br /> NY O-PETERSON CO.INC. STATE SURCHARGE PLBG(VALUATION) 2.50 <br /> 660 280TH. STREET TOTAL 65.00 <br /> MN 5088- <br /> (95 461-2749 PAID WITH CC# 2234 <br /> Mi esota State License#: 058650 <br /> OWNER <br /> KE EY,JOHN&MARY <br /> 319 SUSSEX RD <br /> LO G LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the pproved plans and specifications,app►icable City approvals,and the <br /> Sta Building Code. This permit is for only the work described and does <br /> not ant permission for additional or related work which requires separate <br /> pe its. All provisions of laws and ordinances goverting this type of work <br /> sh I be compied with whether or not specified herein.This permit will <br /> ex re and become null and void if construction authorized is not <br /> co menced within 1 SO days of the date of issuance,or if construction is <br /> sus ended for a period of 180 days at any time after work has commenced. <br /> Th applicant is responsible for assuring all required inspections aze <br /> req ested in confor►nance with the State Building Code.This permit may be <br /> rev ked at y time for due ause. � <br /> / / � � <br /> A an erm ee ture Date Issued Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />