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CITY OF ORONO 1111 11 1111 111 1 II I II <br /> * 20 1 5 - 0 1 5 94 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 12/28/2015 <br /> ORONO,MN 55356- <br /> (952)249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2606 WEST LAFAYETTE RD <br /> PIN : 21-117-23-21-0001 <br /> LEGAL DESC : REG. LAND SURVEY NO.0131 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (10 WATER CLOSET,(2)LAVATORIES AND(1)SHOWER <br /> VALUATION OF PLUMBING 2995 <br /> APPLICANT PLUMBING FIXTURE FEE 50.00 <br /> STATE SURCHARGE PLBG(VALUATION) 1.50 <br /> B&D PLUMBING&HEATING INC. <br /> 4145 MACKENZIE CT NE TOTAL 51.50 <br /> ST MICHAEL,MN 55376- Payment(s) <br /> (763)497-2290 CHECK 552074 51.50 <br /> OWNER <br /> EKHOLM,PAUL&L <br /> 2606 WEST LAFAYETTE RD <br /> EXCELSIOR,MN 55331 <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 y time for due c use. r <br /> a. �G�- /2 �—� 4 8"/ <br /> Applicant Permitee Signature Date Issued Signature Date <br />