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CITY OF ORONO * 2 0 1 5 - 0 0 5 9 7 * <br /> ' 2750 KELLEY PARKWAY DATE ISSUED: OS/14/2015 <br /> ORONO, MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 763 BRIDGEWATER DR <br /> PIN : 33-118-23-12-0091 <br /> LEGAL DESC : STONEBAY SEVENTH ADDITION <br /> : LOT 4 BLOCK 1 <br /> PERMIT TYPE : PLUMBING(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : FIXTURES-MULTIPLE <br /> NOTE: 3 WATER CLOSET,4 LAVATORY, 1 BATHTUB,2 SHOWER, 1 KITCHEN SINK, l DISPOSAL, I DISHWASHER, <br /> 2 SILCOCKS, 1 FLOOR DRA[NS, 1 LALTNDRY TRAY, 1 WASHER, 1 WATER HEATER, 1 WET BAR, 1 MISCELLANEOUS <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 33284 167.70 <br /> (651)786-4007 <br /> Minnesota State License#: plbg-058799PM,mech-MB005379 <br /> OWNER <br /> Wooddale Builders <br /> 6117 BLUE CIRCLE DRIVE <br /> MINNETONKA, MN 55343- <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 /> pertnits. A►I 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 I80 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 /> .S-��_IS ��� � l � �l � <br /> Applicant Permitee Signature Date Issued By Signature Date <br />