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CITY OF ORONO * 2 0 1 6 - 0 1 2 4 1 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 09/30/2016 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952)249-4616 <br /> ADDRESS 200 TRUFFULA TR <br /> PIN 33-118-23-44-0039 <br /> LEGAL DESC MEADOW WOOD POND <br /> LOT 005 BLOCK 001 <br /> PERMIT TYPE PLUMBING <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURES-MULTIPLE <br /> NOTE: REPLACE: 1 WATER CLOSET,4 LAVATORY, 1 SHOWER <br /> VALUATION OF PLUMBING 4000 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 2.00 <br /> JANECKY PLUMBING INC. MAIL-IN FEE 2.00 <br /> 720 PONTIAC PLACE <br /> MENDOTA HEIGHTS,MN 55120- TOTAL 54.00 <br /> Payment(s) <br /> (651)454-9297 <br /> Minnesota State License#:plbg-PC643115 CREDIT CARD 8056 54.00 <br /> OWNER <br /> ADAMS,DONALD&SHEILA <br /> 200 TRUFFULA TR <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 A� _ <br /> revoked at any time for due cause. �(J� <br /> Applicant Permitee Signature Date Issued By Signature Date <br />