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MHERUMIRM <br /> ` CITY OFORONO * 2013 - 00423 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 05/29/2013 <br /> ORONO,MN 55356- <br /> (952) 249-4600 FAX: (952)249-4616 <br /> ADDRESS 3760 WATERTOWN RD <br /> PIN 32-118-23-31-0005 <br /> LEGAL DESC HILLAWAY FARM <br /> LOT 002 BLOCK 001 <br /> PERMIT TYPE PLUMBING(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIXTURES-MULTIPLE <br /> NOTE: IST FLOOR:2 WC,2 LAV,2 TUB, 1 KITCHEN SINK, 1 SILLCOCKS, 1 WASHER, 1 WATER HEATER <br /> 2ND FLOOR: 1 WC, 1 LAV, 1 TUB, <br /> VALUATION OF PLUMBING 6100 <br /> APPLICANT PLUMBING FIXTURE FEE 76.25 <br /> M& S PLUMBING STATE SURCHARGE PLBG(VALUATION) 3.05 <br /> 23581 HEATHER ST NW <br /> ST FRANCIS,MN 55070- TOTAL 79.30 <br /> (763)258-7488 <br /> Minnesota State License#: PC643819 <br /> OWNER <br /> STEPHENSON,REVIS <br /> 3760 WATERTOWN RD <br /> MAPLE PLAIN,MN 55359- <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 tinic for due cause. <br /> Applicant Permitee Signature Date Issued By Sigloture Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />