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CITY OF ORONO III 111111111III 1111 1111111111111111111 <br /> • 2750 KELLEY PARKWAY DATE ISSUED: 02/17/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2610 WEST LAFAYETTE RD <br /> PIN : 21-117-23-24-0043 <br /> LEGAL DESC : SHORE HILLS <br /> : LOT 011 BLOCK 000 <br /> PERMIT TYPE : PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: REPLACE:4 WATER CLOSETS,5 LAVATORY,3 BATHTUB,2 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER, 1 <br /> LAUNDRY TRAY, <br /> 1 WASHER, 1 WET BAR <br /> VALUATION OF PLUMBING 8500 <br /> APPLICANT PLUMBING FIXTURE FEE 106.25 <br /> STATE SURCHARGE PLBG(VALUATION) 4.25 <br /> SANTEMA PLUMBING,INC. TOTAL 110.50 <br /> 4407 LOCKE AVE SW Payment(s) <br /> COKATO,MN 55321 CREDIT CARD 4719 110.50 <br /> Minnesota State License#:plbg-643774,mech-005060 <br /> OWNER <br /> ENQUIST,CYNTHIA <br /> 2610 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 at any time for due cause. • <br /> �J <br /> -/7-/ c.7.,;\ I ..mss u ) `7� 1 , <br /> Date <br /> Applicant Permitee Signature Date Issued By Signature <br />