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CITY OF ORONO * z 0 1 5 - 0 0 5 9 6 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/14/2015 <br /> � ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 761 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0092 <br /> LEGAL DESC : STONEBAY SEVENTH ADDITION <br /> : LOT 5 BLOCK 1 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: (3)WATER CLOSETS,(4)LAVATORIES,(1)BATHTUB,(2)SHOWERS,(1)KITCHEN SINK,(1)DISHWASHER,(1)DISPOSAL,(2) <br /> SILLCOCKS, <br /> (i)FLOOR DRAIN,(1)LAUNDRY TRAY,(1)WASHER,(1)WATER HEATER,(l)WET BAR,(1)MISC <br /> VALUATION OF PLUMBING 12900 <br /> APPLICANT PLUMBING FIXTURE FEE 161.25 <br /> STATE SURCHARGE PLBG(VALUATION) 6.45 <br /> SCHULTIES PLUMBING TOTAL 167.70 <br /> 1521 94TH LANE NE Payment(s) <br /> BLAINE,MN 55449 CHECK 33283 167.70 <br /> (651)786-4007 <br /> Minnesota State License#: plbg-058799PM,mech-MB005379 <br /> OWNER <br /> Stonebrook Development LLC <br /> 17149 LINCOLN ST NE <br /> #600 <br /> HAM LAKE,MN 55304- <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 goveming 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 l80 days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all requiced inspections are <br /> cequested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> � / <br /> ,, S � �i'-,S �� �- ll� i/-�` <br /> , <br /> Applicant Permitee Signature Date Issu By Signature Date <br />