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11111111111111111111 11111M <br /> CITY OF ORONO * 2014 - 00062 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 01/22/2014 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS 3740 TOGO RD <br /> PIN : 17-117-23-31-0023 <br /> LEGAL DESC TOWNSITE OF LANGDON PARK <br /> LOT 000 BLOCK 010 <br /> PERMIT TYPE PLUMBING(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURES-MULTIPLE <br /> NOTE: (1)WATER CLOSET,(1)LAVATORY,(1)SHOWER,(1)FLOOR DRAIN,(1)LAUNDRY TRAY,(1)WASHER AND(1)WET BAR <br /> VALUATION OF PLUMBING 2500 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> WATERTOWN PLUMBING STATE SURCHARGE PLBG(VALUATION) 1.25 <br /> 604 HILLSIDE DRIVE NW TOTAL 51.25 <br /> WATERTOWN,MN 55388- Payment(s) <br /> (952)255-8212 CHECK 5995 51.25 <br /> Minnesota State License#: plbg-PC644088 <br /> OWNER <br /> EMERY, DARYL&KRISTI <br /> 3740 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 /> revokedat any 'me for due cause. <br /> / ZIAfdi�y <br /> Ap scant Permitee Signature Date Iss Signature Date <br />