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CITY OF ORONO PERMIT NO.: 2011-01404 <br /> 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 11/07/2011 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS 1035 TONKAWA RD <br /> PIN : 08-117-23-24-0004 <br /> LEGAL DESC CARLWOOD <br /> LOT 003 BLOCK 001 <br /> PERMIT TYPE PLUMBING(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURES-MULTIPLE <br /> NOTE: PLUMBING FIXTURES: <br /> (6)WATER CLOSETS,(6)LAVATORIES,(5)BATHTUBS,(1)SHOWER,(1)KITCHEN SINK,(1)DISPOSAL,(2)DISHWASHERS, <br /> (1)SILLCOCK(1)WASHER,(2)WATER HEATERS,(1)WATER SOFTENER,(1)STEAM SHOWER AND(1)R.O. <br /> VALUATION OF PLUMBING 20000 <br /> APPLICANT PLUMBING FIXTURE FEE 250.00 <br /> MIKE LARSON PLUMBING STATE SURCHARGE PLBG(VALUATION) 10.00 <br /> 5120 HOOPER LAKE ROAD TOTAL 260.00 <br /> DEEPHAVEN,MN 55331- <br /> 0 <br /> OWNER <br /> BARNETT,MARY ANN <br /> 1035 TONKAWA RD <br /> LONG LAKE,MN 55356- <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 /> revoke y ti a due cause. <br /> // 7 1 <br /> A i Permitee Signature Date Issu By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />