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CITY OF ORONO <br /> * 2012 - 00381 * <br /> J 2750 KELLEY PARKWAY DATE ISSUED: 05/09/2012 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 3645 TOGO RD <br /> PIN 17-117-23-31-0034 <br /> LEGAL DESC TOWNSITE OF LANGDON PARK <br /> LOT 006 BLOCK 010 <br /> PERMIT TYPE PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 5 WATER CLOSET,7 LAVATORY,3 BATHTUB,2 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER,2 SILCOCKS, 1 <br /> FLOOR DRAIN, 1 LAUNDRY TRAY, 1 WATER HEATER <br /> VALUATION OF PLUMBING 10000 <br /> APPLICANT PLUMBING FIXTURE FEE 125.00 <br /> SERVEY PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.00 <br /> 10609 166TH ST W TOTAL 130.00 <br /> LAKEVILLE,MN 55044 <br /> (952)393-1272 PAID WITH CC# 6464 <br /> OWNER <br /> ZHUK,ROMAN&ELENA <br /> 3645 TOGO RD <br /> WAYZATA,MN 55391- <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 governing 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 du <br /> Applicant Permite a ure Date <br /> Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />