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CITY OF ORONO PERMIT NO.: 2009-00241 <br /> • 2750 KELLEY PARKWAY <br /> ORONO,MN 55356- DATE ISSUED: 05/20/2009 <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 4701 WEST BRANCH RD <br /> PIN : 07-117-23-22-0016 <br /> LEGAL DESC : WEST BRANCH ACRES <br /> : LOT 001 BLOCK 001 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 5 WATER CLOSET,7 LAVATORY,3 BATHTUB, 1 SHOWER, 1 KITCHEN SINK, 1 DISHWASHER,2 SILICOCKS, 1 FLOOR <br /> DRAIN,2 WASHER, 1 WATER HEATER, 1 WATER SOFTNER, 1 WET BAR <br /> VALUATION OF PLUMBING 12000 <br /> APPLICANT PLUMBING FIXTURE FEE 150.00 <br /> BEN SCHORER PLUMBING&HVAC INC. STATE SURCHARGE PLBG(VALUATION) 6.00 <br /> 4520 85TH STREET SE <br /> DELANO,MN 55328- TOTAL 156.00 <br /> (763)972-8137 <br /> OWNER <br /> ALBERTSON,DAVID&WENDI <br /> 4701 WEST BRANCH RD <br /> MOUND,MN 55364- <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 f assuring all required inspections are <br /> requested in conformance with State Building Code.This permit may be <br /> L---'- <br /> revoked a ' e or due caus zO,_ <br /> / / , e,,/,(__,t ( frizee,i / / <br /> Applicant Pet7fiitee Signature Date Issued By Signature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. <br />