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CITY OF ORONO * 2 0 1 6 — 0 1 3 8 9 <br /> 2750 KELLEY PARKWAY DATE ISSUED: 11/0112016 <br /> • ORONO,MN 55356- <br /> ` (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1175 MOONEY LAKE DR <br /> PIN : 25-118-23-41-0017 <br /> LEGAL DESC : MOONEY LAKE PRESERVE <br /> : LOT 8 BLOCK 1 <br /> PERMIT TYPE PLUMBING <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: NEW:5 WATER CLOSETS,6 LAVATORY,4 SHOWER, 1 KITCHEN SINK, 1 DISPOSAL, 1 DISHWASHER,3 SILLCOCKS, <br /> 1 FLOOR DRAINS, 1 LAUNDRY TRAY, 1 WASHER, 1 WATER HEATER, 1 WET BAR,BACKFLOW DEVICE: PVB <br /> VALUATION OF PLUMBING 14000 <br /> APPLICANT PLUMBING FIXTURE FEE 175.00 <br /> STATE SURCHARGE PLBG(VALUATION) 7.00 <br /> KRG PLUMBING INC TOTAL 182.00 <br /> 1168 IFFERT AVE SE <br /> BUFFALO,MN 55313- <br /> Payment(s) <br /> (612)282-5041 CREDIT CARD 6188 182.00 <br /> Minnesota State License#:plbg-PC644046 <br /> OWNER <br /> ADELMAN,TIMOTHY <br /> 4545 TRILLIUM DRIVE <br /> MEDINA,MN 55340- <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. (1V7 <br /> 1sc.. , / <br /> Applicant '-rmi ee Signature Date Issued By Signature Date <br />